Abstract
Massive rotator cuff tears (MRCTs) present a persistent clinical challenge, with reported failure rates as high as 40%, largely as the result of factors such as tendon retraction and poor tissue quality. Traditional techniques, including extensive release and mobilization, have yielded limited success in securing stable tendon-to-bone healing. Recent literature suggests that interposition grafts may effectively bridge the gap in these cases. The biceps tendon, because of its structural strength and biological compatibility, has shown promise in providing additional support for MRCT repair. By reducing tension across the repair site and promoting tissue healing, biceps tendon augmentation enables repositioning of the tendon edge to the lateral footprint, improving both repair stability and long-term outcomes. This approach offers an innovative, biomechanically sound alternative for addressing the limitations of direct repair in MRCTs.