Editorial Commentary: Massive Rotator Cuff Tears Benefit From Arthroscopic Repair Regardless of Advanced Goutallier or Hamada Changes.

Massive rotator cuff tears are a challenge to treat, with options available from arthroscopic rotator cuff repair to reverse shoulder arthroplasty. Arthroscopic repair may still be an option even in the setting of advanced Goutallier changes and Hamada grades and regardless of healing. As the lifetime risk of revision for a 55-year-old patient having a reverse shoulder arthroplasty is approximately 1 in 3, arthroscopic surgical management of massive rotator cuff tears should not be discounted. An individualized approach should consider the patient's radiographs (severity of arthritis), function (i.e., acute vs chronic pseudoparalysis), and goals (overhead strength vs pain relief). Younger patients with less arthritis, acute pseudoparalysis, and a focus on pain relief could benefit from arthroscopic treatment.