Forty-two cases tend to disprove the conception that a diagnosis of a rupture of the rotator cuff should be based on the inability of a patient to abduct the arm well and that the "drop arm" test is a good diagnostic sign. All patients with a chronic rupture had good abduction, but the predominating complaint was pain. Arthrography confirmed the diagnosis. When large defects with retraction were found at operation, anatomical reposition was often impossible. In ten such patients the intra-articular portion of the long head of the biceps was used as a free graft by sectioning the tendon in a book-like fashion. The end results were quite satisfactory in nine patients who obtained a good range of motion with definite decrease in pain.