Open Repair of Severe Rotator Cuff Tears

  • Robert J. Neviaser
  • Andrew S. Neviaser


For the purpose of this chapter, severe tears are defined as massive, acute tears that can be repaired or reconstructed. These are challenging and can be addressed via mini-open or open techniques. Ones that occur following a primary anterior dislocation often can be repaired acutely, while alternative techniques such as partial repairs, tendon transfers, and interpositional grafts may be necessary for those that cannot be restored to their original insertion. In addition to history and physical exam, MRI can be helpful preoperatively for planning which surgical approaches might be necessary.


Rotator cuff Tears Rupture Repair Tendon transfers Grafts Diagnosis Management 


  1. 1.
    Neviaser RJ, Neviaser TJ, Neviaser JS. Concurrent rupture of the rotator cuff and anterior dislocation of the shoulder in the older patient. J Bone Joint Surg. 1988;70-A:1308–11.CrossRefGoogle Scholar
  2. 2.
    Bassett RW, Cofield RH. Acute tears of the rotator cuff. The timing of surgical repair. Clin Orthop Relat Res. 1983;175:18–24.Google Scholar
  3. 3.
    Neviaser JS. Ruptures of the rotator cuff of the shoulder. New concepts in the diagnosis and treatment of chronic ruptures. Arch Surg. 1971;102:483–5.CrossRefPubMedGoogle Scholar
  4. 4.
    Neviaser JS, Neviaser RJ, Neviaser TJ. The repair of chronic massive ruptures of the rotator cuff by use of a freeze-dried rotator cuff. J Bone Joint Surg. 1978;60-A:681–4.CrossRefGoogle Scholar
  5. 5.
    Cofield RH. Subscapular muscle transposition for repair of chronic rotator cuff tears. Surg Gynecol Obstet. 1982;154:667–72.PubMedGoogle Scholar
  6. 6.
    Neviaser RJ, Neviaser TJ. Transfer of the subscapularis and teres minor for massive defects of the rotator cuff. In: Bayley J, Kessel L, editors. Shoulder surgery. Heidelberg: Springer Verlag; 1982. p. 60–9.CrossRefGoogle Scholar
  7. 7.
    Birmingham PM, Neviaser R. Outcome of latissimus dorsi transfer as a salvage procedure for failed rotator cuff repair with loss of elevation. J Shoulder Elbow Surg. 2008;17:871–4.CrossRefPubMedGoogle Scholar
  8. 8.
    Neviaser RJ, Neviaser TJ. Major ruptures of the rotator cuff. In: Watson M, editor. Practical shoulder surgery. New York: Grune and Stratton; 1985. p. 171–224.Google Scholar
  9. 9.
    Neviaser AS, Neviaser RJ. Open repair of rotator cuff tears. In: Lee DH, Neviaser RJ, editors. Shoulder and elbow surgery. Philadelphia: Elsevier; 2011. p. 63–86.CrossRefGoogle Scholar
  10. 10.
    Neviaser RJ, Neviaser TJ. Reoperation for failed rotator cuff repair: analysis of 50 cases. J Shoulder Elbow Surg. 1992;1(6):283–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryThe George Washington University School of Medicine, GWU-MFAWashington, DCUSA

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