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.
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