Treatment options for massive irreparable rotator cuff tears (RCT) in younger active adult patients are those intended to induce a biologic response and provide mechanical effect. Cellular augmentation such as platelet-rich matrices stem cells may platform healing. The effect of superior capsule reconstruction, tendon transfers, bridging grafts mitigate migration the humerus stable fulcrum arm ...

Massive, irreparable rotator cuff tears are challenging to treat and associated with pain and severe limitation in shoulder elevation due to the proximal migration of the humeral head and, consequently, subacromial impingement. Furthermore, retraction of the tendons in combination with fat infiltration and muscular weakness results in unpredictable treatment outcomes. While conservative treatme...

BACKGROUND Massive rotator cuff tears in active patients with minimal glenohumeral arthritis remain a particular challenge for the treating surgeon. METHODS A selective literature search was performed and personal surgical experiences are reported. RESULTS For patients with irreparable rotator cuff tears, a reverse shoulder arthroplasty or a tendon transfer are often performed. However, bot...

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Whereas arthroscopic superior capsule reconstruction has recently been introduced to treat irreparable rotator cuff tears with encouraging outcomes, graft options and fixation remain debated. The purpose of this article is introduce a modified technique using the long head biceps tendon as augmentation for fascia lata autograft.