Current Concepts Review   |    
Massive Tears of the Rotator Cuff
Asheesh Bedi, MD1; Joshua Dines, MD2; Russell F. Warren, MD2; David M. Dines, MD2
1 MedSport, University of Michigan, 24 Frank Lloyd Wright Drive, Lobby A, Ann Arbor, MI 48106. E-mail address: abedi@umich.edu
2 Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail address for J. Dines: dinesj@hss.edu. E-mail address for R.F. Warren: warrenr@hss.edu. E-mail address for D.M. Dines: ddinesmd98@aol.com
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Biomet, Warsaw, Indiana).

Investigation performed at the Hospital for Special Surgery, New York, NY

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Aug 04;92(9):1894-1908. doi: 10.2106/JBJS.I.01531
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Repair of massive rotator cuff tears is technically difficult but often feasible. Technical and biological challenges to a successful repair include inelastic poor-quality tendon tissue, scarring, muscle atrophy, and fatty infiltration.

Fatty infiltration of the involved rotator cuff muscles has been identified as an important negative prognostic factor for the outcome after repair of massive rotator cuff tears.

Tendon transfer is a good option for young patients and manual laborers with an irreparable massive rotator cuff tear.

Arthroplasty can be considered for the treatment of symptomatic massive rotator cuff tears in patients who have glenohumeral arthritis.

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