Rotator cuff tears are most commonly the result of age-related degenerative pathology, although they can result from trauma at any age. Patients with rotator cuff tears (RCT) often present with pain, loss of strength and decreased range of motion, which significantly affects their function and quality of life. Some uncertainty persists about optimal treatment strategies and the timing of repairs for some RCTs. The incidence of rotator cuff repairs has rapidly increased in recent years, and studies show that the vast majority of patients go on to experience significant improvements in pain and function, although re-tear is a recognized complication. Novel strategies using grafts to augment repairs are being employed in the hope of reducing these re-tear rates. Augments are expensive and currently not fully supported by high-quality evidence demonstrating their efficacy. The management of larger, potentially irreparable cuff tears is challenging. It remains unclear whether surgery offers effective long-term results for most patients with large and massive cuff tears, as rotator cuff repairs for this cohort are associated with high failure rates.
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