Abstract
Massive rotator cuff tears present a difficult problem for orthopaedic surgeons to treat and can severely influence quality of life. Unlike small full thickness rotator cuff tears, massive tears are more unpredictable when fixation is attempted and various factors influence outcomes including poor tissue quality, muscle atrophy, fatty infiltration and tendon retraction. The biceps tendon is a known pain generator in patients with rotator cuff pathology. Many patients with large rotator cuff tears can gain excellent function. Prolonged immobilization and physical therapy following attempted repair can lead to additional hardship and pain. A simple arthroscopic debridement and biceps procedure in some cases can improve pain and lead to a quicker recovery. In this article, we describe our preferred surgical technique for arthroscopic debridement and biceps tenotomy or tenodesis when clinically indicated.
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