Abstract
In the current literature, several definitions are provided for massive cuff tears. At the same time, a massive cuff tear can be reparable or irreparable. As a consequence, certain criteria need to be defined to address this issue of reparability—quality of tendon, status of muscle atrophy, bone of greater tuberosity, status of glenohumeral joint, and last but not least the clinical criterion, that is the functionality of shoulder. Several arthroscopic treatment options are described — from simple biceps tenotomy, partial reconstruction techniques with or without biologic augmentation, and superior capsule reconstruction to other rather new tools such as balloon spacer implantation.