Treatment of irreparable rotator cuff tears

Irreparable rotator cuff tears are a challenging problem for patients and surgeons. There are several treatment options, but deciding the correct one for each patient can be difficult. Treatment options include physical therapy, arthroscopy, muscle transfers, reverse shoulder arthroplasty, and hemiarthroplasty. An understanding of the patient's chief complaint and their functional ability to elevate their arm above horizontal should guide the treatment. This article reviews the current literature on various treatment options for irreparable rotator cuff tears, then outlines an algorithm for determining treatment.