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Updated: Jul 16, 2026
Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
Clinical outcomes and structural integrity after arthroscopic partial repair with patch augmentation for large to
Chang Hee Baek1, Bo Taek Kim1, Jung Gon Kim1
1Department of Orthopaedic Surgery, Yeosu Baek Hospital, Yeosu, Jeollanam-do, Republic of Korea.
Introduction:
Complete anatomic repair of large to massive rotator cuff tears (RCTs) is often not feasible because of tendon retraction, poor tissue quality, and advanced muscle degeneration. This study evaluates short-term clinical outcomes, complications, and postoperative structural integrity following arthroscopic partial rotator cuff repair with patch augmentation in patients with large to massive rotator cuff tears.
Methods:
From May 2023 to December 2023, patients who underwent arthroscopic partial rotator cuff repair with patch augmentation for large to massive RCTS were retrospectively reviewed. Inclusion criteria were full-thickness supraspinatus tears with or without infraspinatus involvement, anteroposterior tear size >30 mm, and intraoperative confirmation that complete footprint coverage was not achievable. Exclusion criteria were loss to follow-up, prior shoulder instability surgery, and incomplete clinical data. Clinical outcomes were assessed preoperatively and at final follow-up using VAS pain, Constant, ASES, and SANE scores, range of motion (ROM), and forward elevation strength. Postoperative cuff integrity was evaluated with MRI, with subgroup analyses based on repair integrity.
Results:
After exclusion of 16 patients, 90 patients were included, with a mean follow-up duration of 26.3 ± 2.1 months. Significant improvements were observed in pain, patient-reported outcome measures, ROM, and shoulder strength at final follow-up compared with preoperative values (all p < .001). Postoperative retear occurred in 18 patients (20.0%). Patients with intact repairs showed significantly superior pain relief, functional outcome scores, ROM, and strength compared with those who experienced retears (all p < .001). Other complications included shoulder stiffness in 8 patients (8.9%), infection in 2 patients (2.2%), and progression of glenohumeral arthritis in 3 patients (3.3%).
Conclusion:
Arthroscopic partial repair with patch augmentation resulted in significant short-term improvements in pain, functional outcomes, ROM, and shoulder strength in patients with large to massive RCTs. Patients with intact repairs demonstrated superior clinical outcomes and achieved higher rates of clinically meaningful improvement compared with those in the retear group.
Study Design:
Case series; Level of evidence, IV.
