A Transosseous Suture Technique for Rotator Cuff Repair in Patients With Severe Osteoporosis

Suture anchor-based repair is widely regarded as the standard technique for rotator cuff tears; however, in patients with severe osteoporosis, anchor pullout remains a major concern. Classical transosseous rotator cuff repair provides favorable biomechanical strength and avoids anchor-related complications but has several inherent limitations. We describe a transosseous rotator cuff repair technique that simulates the function of the medial-row anchor in anchor-based repair, specifically for rotator cuff tears associated with severe osteoporosis. This technique combines favorable biomechanical performance with a straightforward surgical procedure, a flexible suture configuration, and a relatively low risk of complications and may serve as an effective alternative for rotator cuff repair in patients with compromised bone quality.