With current surgical techniques, open rotator cuff repair can provide significant functional improvement and pain relief in the majority of patients. Important principles include performing anterior acromioplasty, bursal resection, rotator cuff mobilization, tension-free repair to the greater tuberosity with nonabsorbable sutures, and meticulous deltoid repair. In massive rotator cuff tears, the coracoacromial ligament should be repaired to prevent anterosuperior instability, and partial repair of the rotator cuff is recommended over performing transfer procedures. Postoperative rehabilitation requires the patient to avoid active exercises for 6 weeks and weights for 3 months. With these techniques, 85% to 90% satisfactory results can be expected.
