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Failure rates after rotator cuff repair remain high in patients with massive tears.
Rotator cuff tears affect 40% or more of those over age 60, and the repair failure rate of large to massive tears ranges from 20 to 90%.
Whereas most rotator cuff tears are amenable to suture repair, the overall success rate of repair is low, and massive tears are prone to re-tear.
As a less invasive surgery of the shoulder, the mini-open repair was carried out from March 1997 through December 1998 in 22 patients (mini-open repair group) for all types of rotator cuff tears, except massive tears.
Both non-operative and operative treatment options for massive tears follow, including arthroscopy, the use of biologics and patches, tendon transfers, and hemiarthroplasty and reverse total shoulder arthroplasty.
In massive tears, convergence sutures were placed first to lateralize the free margin of the tear, and then suture anchors were placed to repair the rotator cuff to the bone by single-row fixation technique.
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The horn blower's sign will test for a massive tear or a tear of the teres minor muscle.
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In terms of clinical findings, the massive tear group showed a higher incidence of pseudoparalysis.
Consistent with our findings, Oh et al [ 34], reported that pseudoparalysis was not associated with poorer results in patients with large or massive tear.
22 patients had a full thickness tear of SSP tendon, 32 of the SSP and ISP tendons, 20 of the SSP and SSC tendons, and 19 showed a massive tear with involvement of all three tendons.
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