The main lifter of the shoulder joint is called the rotator cuff which is a group of 4 muscles arranged from front to back of the shoulder. The rotator cuff can tear due to degeneration- wear and tear/trauma- fall.
Usually, its repaired by a procedure called arthroscopic rotator cuff repair, but in neglected cases, the cuff muscles will be deficient and it is impossible to repair the tissue.
The options after this are limited, and usually, answer to this is irreparable tear is to do a reverse shoulder arthroplasty(shoulder replacement).
Dr. Nair has trained with Dr.Mihata the architect of SCR and regularly does superior capsular reconstruction, where a muscle graft from the thigh is used to augment the defective tear giving excellent results in 3 months.