An analysis of failure rates for treatment options for large to massive irreparable rotator cuff tears: a systematic review

Background: A variety of treatment methods for irreparable rotator cuff tears (RCTs) have been proposed, yet there is no conclusive evidence showing any to be superior. This review aims to use failure rates to compare different treatment methods for irreparable RCTs with the goal of identifying which methods are superior. Methods: The studies in this review included patients with large to massive irreparable RCTs and reported failure rates. Seven treatment categories were identified: arthroscopic débridement, subacromial balloon spacer, interposition graft repair, partial repair, reverse total shoulder arthroplasty, superior capsule reconstruction, and tendon transfers. The failure rates for the groups were compiled and compared, as this was the only common outcome measurement between all studies. Results: ≥ .100). Discussion: While this review did not identify a single best treatment for irreparable RCTs, it did provide valuable insights into the reliability of different treatments. The results were able to develop a hierarchy based on failure rate, which could help guide treatment for irreparable RCTs.