Reconstructive surgery for massive rotator cuff tear

Surgical Principles The rotator cuff is repaired with transosseous sutures if possible. If the defect is too large for direct repair, local muscle or tendon transfers are used. An anterior acromioplasty with resection of the coraco-acromial ligament is performed in every case. In absolutely irreparable tears the authors recommend an open or arthroscopic debridement combined with an anterior acromioplasty and a resection of the lateral end of the clavicle. Should a cuff tear arthropathy exist, shoulder replacement or an arthrodesis should be considered. Revised Version from: Operat. Orthop. Traumatol. 4 (1992), 161–178 (German Edition).