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Updated: Jan 24, 2026

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
Non-anatomic arthroscopic repair of massive rotator cuff tears versus anatomic complete arthroscopic repair: a
M-A Malahias1, G Avramidis2, E Brilakis2
13rd Orthopaedic Department, HYGEIA Hospital, Erythrou Stavrou 4, Marousi, 15123, Athens, Greece. alexandermalahias@yahoo.gr.
Purpose:
To investigate whether a non-anatomic arthroscopic repair of massive rotator cuff tear (RCT) produces satisfactory clinical outcomes comparable to those of an anatomic complete arthroscopic repair.
Methods:
A retrospective case-control study (prospectively collected data, mean follow-up: 32.7 months ± 29.5; range 12-80 months) was conducted with patients with massive RCT who underwent either an anatomic complete arthroscopic repair (group A: 34 patients) or a non-anatomic arthroscopic repair (partial repair or medialized repair, group B: 30 patients). The rate of success was calculated primarily by the number of patients per group who achieved a minimal clinically important difference between the preoperative and postoperative values of (a) the American Shoulder and Elbow Surgeons Shoulder Score, (b) the constant score and (c) secondarily, the visual analogue scale (VAS-pain). Active range of motion (shoulder forward flexion, abduction, external rotation in 0° and 90° abduction), muscle strength and external rotation lag sign were also assessed.
Results:
No significant statistical differences amongst groups were found concerning the baseline demographic and clinical characteristics. All postoperative clinical and functional scores were significantly improved in both groups (p < 0.001). According to our primary and secondary success rate criteria, both treatments were found to be successful, whereas there was no significant difference amongst them.
Conclusions:
Non-anatomic arthroscopic repair of massive RCT illustrated satisfactory outcomes, which are not significantly different from those reported after an anatomic complete arthroscopic repair.
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