When the Cuff Is Gone but the Patient Isn’t Ready for a Prosthesis

Massive irreparable rotator cuff tears (MIRCTs) in the posterosuperior shoulder remain one of the more humbling problems in sports medicine. The tendon is gone. The muscle is fatty. The humeral head is migrating north. And the patient — often in their early 60s — is not thrilled about the words “reverse shoulder arthroplasty.”