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Updated: Feb 9, 2026

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
Treatment Strategy for Irreparable Rotator Cuff Tears
Joo Han Oh1, Min Suk Park1, Sung Min Rhee1
1Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Rotator cuff tears (RCTs) are common in older adults and can be irreparable in up to 30% of cases. This review covers treatment options and surgical strategies for managing irreparable massive RCTs.
Area of Science:
- Orthopedics
- Sports Medicine
- Musculoskeletal Research
Background:
- Shoulder pain and rotator cuff tears (RCTs) are increasingly prevalent, particularly in middle-aged and older adults.
- RCTs are a leading cause for shoulder surgery in the general population.
- A significant subset, up to 30% of RCTs, are classified as irreparable due to large tear size and severe muscle atrophy.
Purpose of the Study:
- To provide a comprehensive overview of current treatment modalities for irreparable massive RCTs.
- To discuss optimal surgical strategies for patients with RCTs requiring operative intervention.
Main Methods:
- Literature review of existing studies on irreparable massive rotator cuff tears.
- Analysis of surgical techniques and treatment outcomes for RCTs.
Main Results:
- Identified various treatment options for irreparable massive RCTs.
- Discussed the nuances of surgical decision-making in complex RCT cases.
Conclusions:
- Effective management of irreparable massive RCTs requires careful consideration of tear characteristics and patient factors.
- Surgical strategies should be tailored to optimize outcomes for patients with severe rotator cuff pathology.
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