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Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
Comparison of partial versus complete arthroscopic repair of massive rotator cuff tears
Nicholas D Iagulli1, Larry D Field, E Rhett Hobgood
1Trinity Orthopedics, Hurst, TX 76054, USA. nickiagulli@hotmail.com
Background:
Complete repair of massive rotator cuff tears can be limited by tendon retraction and poor tissue quality. When a complete repair cannot be accomplished, a significant partial repair may be possible.
Hypothesis:
A partial repair will yield comparable outcomes to complete repair of massive rotator cuff tears in this specific patient population.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
All consecutive arthroscopic rotator cuff repairs done at the authors' institution over a 2-year period were identified. A retrospective chart review was performed. Inclusion criteria required that each patient have a massive rotator cuff tear (30 cm(2) or greater). Patients were categorized as either partial or complete repair. The University of California, Los Angeles (UCLA) shoulder scores were used to measure patient outcomes at an average follow-up of 24 months (10-40 months).
Results:
Of 1128 consecutive arthroscopic rotator cuff repairs, 97 (9%) patients were noted intraoperatively to have massive tears measuring 30 cm(2) or greater. Complete repair was achieved in 52 patients, whereas partial repair was possible in 45 patients. Eleven patients were lost to follow-up. The 41 remaining patients with only partial repair achieved a postoperative mean UCLA score of 29.49, and the 45 patients with complete repair achieved a mean UCLA score of 29.64, yielding significant improvement in both the partial repair group (P = .0001) and the complete repair group (P = .0001) compared with preoperative UCLA scores. However, no statistically significant differences in postoperative outcomes were noted when the 2 groups were compared with one another (P = .89).
Conclusion:
Partial repair of massive rotator cuff tears yielded outcomes comparable with complete repair of massive tears.
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