Tratamiento artroscópico de las roturas masivas del manguito rotador

Summary. The arthroscopic repair of a massive rotator cuff tear, is a technically demanding procedure. It requires correct indications, good arthroscopic skills and a proper rehabilitation program. The clinical study of the patient and the instances of the rotator cuff injury, are fundamental to determine a correct therapeutic stra- tegy. This strategy should consider every option from non-surgical to arthroscopic repair, tendon transfers, su- bacromial spreaders or shoulder arthroplasties. The arthroscopic repair is the standard treatment in patients with massive repairable tears and with no fatty degeneration of the affected muscle. Meanwhile, the tendon transfers are indicated in young patients with highly functional demands that comprehend irreparable massive tears. The spreaders or subacromial balloons and the shoulder prosthesis are performed in irreparable tears in low functio- nal demand patients.