Double Row Rotator Cuff Repair for Massive Reparable Rotator Cuff Tear

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Arthroscopy

Background:

• Massive rotator cuff tears (≥2 tendons or >5 cm diameter) pose surgical challenges due to tissue quality issues and unreliable healing.
• Surgical repair is indicated for acute tears or chronic cases unresponsive to conservative treatment with confirmed large full-thickness tears.
• Contraindications include osteoarthritis, advanced muscle atrophy, significant humeral head migration, and tears exceeding 40 mm.

Purpose of the Study:

• To present a technique for anatomic, double-row repair of massive, reparable rotator cuff tears.
• To demonstrate an arthroscopic approach for complex rotator cuff injuries.

Main Methods:

• The procedure involves patient positioning in lateral decubitus, diagnostic arthroscopy, and subacromial bursectomy.
• Preparation of the humeral head footprint and mobilization of the rotator cuff are performed.
• Medial row anchors are placed, followed by sequential incorporation into lateral row anchors, and subacromial decompression.

Main Results:

• The primary goals are reduced pain and improved shoulder function.
• Postoperative management includes approximately 6 weeks of sling immobilization.
• Initiation of strengthening and range-of-motion protocols follows immobilization.

Conclusions:

• Arthroscopic double-row repair offers an anatomic and stable reduction for massive, reparable rotator cuff tears.
• This technique is suitable for patients who have not responded to conservative management.