Rotator-Cuff Failure

Abstract
A 63-year-old woman presents with a 2-year history of progressive weakness and discomfort in her right shoulder, especially when she puts dishes on the top shelf in her kitchen. She is otherwise healthy and has had no injuries. Physical examination shows some atrophy of the muscles in the right shoulder and weakness when the right arm is elevated. Magnetic resonance imaging shows a large defect in the rotator cuff. How should her case be managed?

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