Margin Convergence in Rotator Cuff Repair: The Shoelace Technique

The concept of margin convergence for side-to-side strain reduction in massive U-type rotator cuff tears has been used to protect the free margin repair to bone. Data in the literature show favorable outcomes for this method of repair. However, one of the challenges when performing side-to-side repair has been the dog-ear deformity that forms at both the convergence split and marginal ends. We present a method of single-suture convergence using a "shoelace" weaving technique, which seems to decrease the incidence of dog-ear deformity, decreases margin strain, and can be incorporated into current transosseous-equivalent rotator cuff repair configurations. The technique is simple and reproducible for large or massive tear patterns.