The Y-Loop for Double-Row Rotator Cuff Repair: An All-Arthroscopic Technique

Rotator cuff tear is a prevalent shoulder condition that poses unique challenges for surgeons. Several locking suture methods based on the concept of single- or double-row fixation have been described and reported to address rotator cuff tears. However, not all methods yield acceptable clinical outcomes. In this article, we describe an all-arthroscopic double-row over-locking suture technique inspired by the H-loop and lark-loop techniques. This method uses a high-strength over-locking suture to create a horizontal stitch configuration that mimics the natural structure of the rotator cuff cable, thereby achieving a tear-resistant loop and initial tendon-to-bone fixation. Final fixation is accomplished using a suture anchor at the greater tuberosity. This technique is easy to perform, requires no additional sutures or stitches, and is particularly suitable for patients with small- to medium-sized rotator cuff tears or tendons of poor quality.