The “massive and irreparable tears of the rotator cuff” are by definition not reparable. It is common to have massive, chronic, and irreparable cuff tear. These tears can be asymptomatic or disabling.
It is recognized that for many patients, non-operative management can substantially improve the comfort and function of the shoulder with a chronic massive tear (see Nonoperative treatment of chronic, massive irreparable rotator cuff tears: a systematic review with synthesis of a standardized rehabilitation protocol). For patients with painful massive, irreparable rotator cuff tears having retained active elevation of the arm, a conservative procedure, the “smooth and move” (see this link), can provide significant benefit and prompt return to activities without the complexity or the risks associated with more aggressive surgeries
Some surgeons suggest partial repair to the massive cuff tear. The authors of Massive and irreparable rotator cuff tears treated by arthroscopic partial repair with long head of the biceps tendon augmentation provides better healing and functional results than partial repair only suggested that partial repair with augmentation using the long head of the biceps would result in a better quality of…
