The rotator cuff. Large and massive tears. Technique of open repair.

Symptomatic large and massive rotator cuff tears can be successfully managed with operative repair. Five factors that facilitate favorable results include: (1) performing an adequate subacromial decompression; (2) maintaining the integrity of the deltoid origin; (3) mobilizing the torn tendons, performing an interval slide when indicated; (4) repairing the tendons to bone; and (5) carefully staging and supervising the rehabilitation program.