Treatment options for chronic retracted degenerative rotator cuff tears

Degenerative, retracted, massive rotator cuff tears present surgeons with distinct challenges. Patient selection is key to a successful outcome. Treatment strategies range from non-operative to progressively more complex surgical options, including debridement, partial repair, complete repair utilizing margin convergence and interval slides, tendon transfers, arthrodesis, and arthroplasty. The rationale behind each of these options and more are discussed along with guidance for selecting the appropriate treatment strategy for individual patients. Outcomes of various treatment approaches are discussed as well to facilitate surgeons to successfully manage patients with retracted and degenerative tears of the rotator cuff.