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Updated: Aug 16, 2025

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[Progress on arthroscopic surgery for massive rotator cuff tears].

Tao Liu1, Ming-Tao Zhang1, Jian-Ping Zhou1

  • 1Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China.

Zhongguo Gu Shang = China Journal of Orthopaedics and Traumatology
|December 26, 2022
PubMed
Summary

Treating massive rotator cuff tears is challenging. Arthroscopic surgery offers options, but the best approach for rotator cuff repair depends on patient factors and tear characteristics.

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Area of Science:

  • Orthopaedic Surgery
  • Sports Medicine
  • Biomedical Engineering

Context:

  • Massive rotator cuff tears present significant surgical challenges, often complicated by retraction, adhesions, and fatty infiltration.
  • Arthroscopic techniques are the gold standard for treating these tears, yet optimal surgical strategies remain debated.
  • Current research focuses on improving repair outcomes for complex rotator cuff injuries.

Purpose:

  • To review and discuss various surgical treatment options for massive rotator cuff tears.
  • To evaluate the indications and potential benefits of different arthroscopic and open surgical techniques.
  • To highlight emerging strategies and ongoing research in rotator cuff repair.

Summary:

  • Arthroscopic debridement, acromioplasty, or tuberoplasty may offer short-term pain relief for elderly patients with low functional demands.
Keywords:
ArthroscopesReviewRotator cuff tears

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  • Biceps tenotomy or tenodesis is effective for associated long head biceps tendon injuries.
  • Complete repair is preferred for massive tears, with partial repair and patch augmentation as alternatives for specific cases.
  • Tendon transfers are recommended for patients with limited shoulder rotation and high functional needs.
  • Superior capsular reconstruction is beneficial for younger, active patients without significant arthritis.
  • Subacromial spacer implantation is a minimally invasive option with promising early results, though long-term efficacy requires further study.

    • Impact:

    • Provides a comprehensive overview of current and emerging surgical treatments for massive rotator cuff tears.
    • Aids orthopaedic surgeons in selecting the most appropriate surgical strategy based on patient-specific factors and tear severity.
    • Informs future research directions for optimizing rotator cuff repair and improving patient outcomes.