Irreparable rotator cuff tears: what to do and when to do it; the surgeon's dilemma.

Irreparable rotator cuff tears have been defined as those tears that because of their size and retraction cannot be repaired primarily. Patients with an irreparable tear present with a variety of symptoms and physical findings, and their management depends on the clinical situation and the specific location of the tear. Most of these tears occur in the older, less active patient and many of these patients are best treated without surgery. For those in whom surgery is indicated, the best procedure should be tailored to the tear.