Review Question - QID 220132

A 65-year-old male presents to clinic for progressive weakness in his right shoulder. His weakness limits his ability to work as a home painter. His shoulder pain began suddenly 5 years ago while lifting weights, but over time, has become almost painless. On exam, shoulder elevation is limited to shoulder to 90 degrees in forward flexion. There is no glenohumeral arthritis on his radiographs. A representative MRI image is shown in Figure 1. He is interested in a procedure that gives him the most reliable outcome and allows him to return to painting homes. What is the mechanism of the most appropriate procedure that will enable him to regain overhead function?