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Related Experiment Video

Updated: Dec 25, 2025

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
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Defining massive rotator cuff tears: a Delphi consensus study.

Adam Schumaier1, David Kovacevic2, Christopher Schmidt3

  • 1Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA.

Journal of Shoulder and Elbow Surgery
|March 22, 2020
PubMed
Summary
This summary is machine-generated.

A consensus definition for massive rotator cuff tears (MRCTs) was established using the Delphi technique. MRCTs involve tendon retraction to the glenoid rim or greater tuberosity exposure, measurable via MRI or intraoperatively.

Keywords:
Delphi techniqueMassive rotator cuff tearclassificationconsensusdefinitionrotator cuff tearshoulder surgery

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Anatomy

Background:

  • A standardized definition for massive rotator cuff tears (MRCTs) is currently lacking.
  • This study aimed to establish a practical, consensus-based definition for MRCTs.

Purpose of the Study:

  • To develop a consensus definition for massive rotator cuff tears (MRCTs) using the modified Delphi technique.
  • To provide a clear and practical definition for identifying and classifying MRCTs.

Main Methods:

  • The modified Delphi technique involved 20 experts over 4 survey rounds.
  • Consensus was defined as at least 70% of responders rating an item as 4 or 5 on a 5-point scale.
  • A literature review informed the initial set of core characteristics, which were then refined.

Main Results:

  • Consensus was reached on tear size, number of tendons torn, and medial retraction degree.
  • Magnetic resonance imaging (MRI) and intraoperative findings were agreed upon as diagnostic modalities.
  • The final definition requires tendon retraction to the glenoid rim and/or ≥67% greater tuberosity exposure, with specific measurement planes defined (coronal/axial for retraction, sagittal for exposure).

Conclusions:

  • A 90% agreement was achieved on the definition of massive rotator cuff tears (MRCTs).
  • The consensus definition specifies tendon retraction to the glenoid rim (coronal/axial plane) and/or ≥67% greater tuberosity exposure (sagittal plane).
  • This definition is applicable using either MRI or intraoperative assessment.