Treatment of massive irreparable cuff tears: Decision making process

Abstract

Massive irreparable rotator cuff tears are defined as rotator cuff tears that cannot be anatomically repaired albeit using advanced arthroscopic techniques because of the size of the lesion, retraction, fatty degeneration, and muscle atrophy. Failure rate of massive tears is high (between 25 and 94%), so in the past years, many treatments have been proposed and used: conservative treatment, isolated biceps tenotomy, suprascapular nerve release, arthroscopic debridement, tuberoplasty, partial repair, superior capsular reconstruction, ballon spacer, muscle transfer, and reverse total shoulder arthroplasty. There is no consensus about which one is the best treatment: the best treatment must be chosen wisely and has to be tailored to the needs of every patient.