Management of Massive Rotator Cuff Tears. A Long Didactic Video.

Video Description

An Extended Review for the Management of Massive and Irreparable Rotator Cuff Tears.
A massive rotator cuff tear is not necessarily irreparable, and an irreparable tear is not always massive. The number of tendons involved, the quality of the tissue, and the decreased acromiohumeral distance are as important as the size of the tear in determining reparability.
Debridement of irreparable tears may be reasonable in patients with low functional demands, but results deteriorate over time.
Patients who do not have pseudoparalysis or advanced cuff tear arthropathy may benefit from biceps tenotomy or tenodesis.
Suprascapular neuropathy has been shown to be a possible neurogenic cause of pain in massive rotator cuff tears.
Tendon transfers offer good results in patients with massive, irreparable rotator cuff tears who have an intact deltoid function and disabling weakness but no pseudoparalysis.