An Arthroscopic Humeral Medializing Repair of the Supraspinatus

Posterosuperior repair of the rotator cuff is one of the most frequently performed surgical procedures in the shoulder. Its aim is to fix the tendon back to the bone to restore anatomy, improve shoulder function, and prevent progression of cuff tear arthropathy and attendant muscle degeneration. Despite technical advances in this procedure, in some cases, the tendon cannot be fixed back to the footprint without excessive tension on the repair. In young patients or in patients with low-grade muscle atrophy and fatty degeneration (Goutallier grade 1 or 2), it is mandatory to attempt fixation of the tendon to restore functional anatomy and prevent further muscle degeneration. In such cases, an arthroscopic medialized reinsertion of the supraspinatus may be considered. We describe an arthroscopic humeral medializing repair of the supraspinatus tendon that allows for a tension-free repair of the supraspinatus using common portals and instruments. The goal of this technique is to obtain tendon healing, restore functional anatomy, and prevent atrophy and fatty degeneration of the muscles of the rotator cuff.