Free coracoacromial ligament graft for augmentation of massive rotator cuff tears treated with mini-open repair

Repair of massive rotator cuff tears is a challenging and complex procedure. The tissue at the end of the torn tendons is often friable and weak, because ruptures are old and degenerated, and thus the ends must be sutured effectively and strongly to achieve a satisfactory outcome. We aimed to evaluate the effectiveness of free total or partial coracoacromial ligament (CAL) graft to protect and augment the repair of massive rotator cuff tears.