Irreparable Tears: The Role for Debridement or Partial Rotator Cuff Repair

Management of massive, retracted rotator cuff tear repair is a difficult task without a consensus algorithm for treatment. Although nonoperative management is appropriate in certain patients, surgical treatment is advocated for younger, more active patients or those with persistent pain. Aggressive surgical options such as rotator cuff repair with patch augmentation, tendon transfers, and reverse total shoulder arthroplasty are options for many patients in which complete anatomical repair of the massive rotator cuff tear is not always surgically possible because of poor tissue quality, tendon loss, severe retraction, or increased tension of the repair. Debridement of the rotator cuff or partial rotator cuff repair offer viable options for patients with goals of pain relief and improvement in range of motion. Although partial repair often does not restore full strength, most patients are satisfied with their overall improvement in function.