Arthroscopic Partial Rotator Cuff Repair for an Irreparable Tear

Massive, irreparable rotator cuff tears can result in significant functional disability and loss of muscle strength. Despite the difficulty, massive cuff tears pose for surgeons and their relatively high incidence, there is no consensus on the optimal surgical treatment method. The rationale for performing arthroscopic partial rotator cuff repair is to turn an irreparable tear into a “functional tear” by restoring the shoulder force couples. Outcome studies for partial repair are generally favorable; however, numerous controversies exist including which should be the exact optimal technique. This article provides a historical framework and the contemporary outcomes associated with arthroscopic partial repair as well as a modified surgical technique of the original description. The authors advocate mobilizing the torn rotator cuff tendon to maximize surface area coverage of the greater tuberosity footprint so as to optimize tendon-bone healing and minimize retear rates.