Due to an arthroscopic’s surgery progress, almost all type of rotator cuff lesions including massive tears can be repaired. Correct preoperative surgical planning needs combination of dates coming from clinical history, diagnostic imaging and the demand of patient.

Purpose: the goal of this study is to report on the arthroscopic repair of massive rotator cuff tear: surgical techniques used, outcome.

Type of study: retrospective study in 2 Orthopedic Center in Rome (Italy).

Methods: Between 2000 and 2007, 457 patients underwent arthroscopic repair of rotator cuff tear: 93 of these were complete massive cuff tear. The pre-op and postoperative outcomes were analyzed using the Costant Score (CS), Simple Shoulder Test (SST), a single question reflecting satisfaction. The patients were divided in 2 group: massive antero-superior and massive postero-superior cuff tear. The average age of patients was: 55–74 yrs; the average time from onset of symptoms to surgery was 16,7 months.

Results: the CS score improved from 0–3 pre-op to 7–10 post op; the SST score from 18–32 pre-op to 68–90. The patient satisfaction rate was > 90%.

Conclusion: The arthroscopic repair of massive rotator cuff tear is an effective procedure for decresing pain and improving function of the shoulder. The patient satisfaction rate is very high. The right indication to surgery, the correct surgical procedure and the appropriate physical terapy are the keys of success.