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In some instances, surgical repair is not able to be performed for rotator cuff tears. Sometimes if the tear has occurred long ago and the tissue quality cannot hold the stitch so that it can be repaired, patients are left with a couple of other options. Tears that can’t be repaired can be managed with something called a reverse shoulder replacement, which is a metal and plastic shoulder replacement that allows for the patient to reach up over their head and usually is very good at eliminating pain. This is a much larger operation than a rotator cuff repair, and the recovery is typically longer.