Arthroscopic Repair of Massive Rotator Cuff Tears

Repair of massive rotator cuff tears presents a challenge due to the large size and technical difficulty of reapproximating the tendon to the bone. Tears large in size retract from the native insertion site and can require surgical release in order to mobilize the tendon to the bone. While no one repair technique or surgical material has definitively proven superior, the important concepts are the same. A biomechanically stronger repair that eliminates gap formation and motion at the tendon to bone interface will maximize the biology of the repair. Effective anchor placement, suture management, and tendon fixation are important components of a good repair. This chapter presents a surgical strategy and discusses the important concepts surrounding repair of a massive rotator cuff tear.