Arthroscopic Side-to-Side Suture Repair for Full-Thickness Transtendinous Supraspinatus Rotator Cuff Tear

Abstract

Background: Full-thickness, transtendinous supraspinatus tears involve a significant portion of the remnant tendon that remains attached to the greater tuberosity footprint. This tear type often leaves insufficient medial tissue for tension-free footprint restoration with traditional repair techniques. In these clinical scenarios, side-to-side suture repair is an effective repair technique. Indications: Indications for this procedure include an acute mechanism of injury, sufficient remnant tendon left on the greater tuberosity, and a medial tear location such that primary repair of the medial tendon would not result in overtensioning of the repair. Technique Description: Following diagnostic arthroscopy, 2 suture tapes are passed through the medial and lateral portion of the tendon surface in a simple side-to-side fashion. Two FiberLink sutures (Arthrex) are then placed in luggage tag fashion, in between the side-to-side sutures within the myotendinous portion of the tear. The suture tapes are then tied in an arthroscopic fashion, completing the side-to-side repair. The looped sutures are then secured through a 4.75-mm BioComposite SwiveLock lateral row anchor (Arthrex) as an added reinforcement to prevent medial retraction of the myotendinous portion of the tear, creating a tension-free environment for optimal tear healing. Results: Available literature suggests that the side-to-side repair technique in patients with transtendinous supraspinatus rotator cuff tears yields excellent outcomes equivalent to that of tendon-to-bone double-row suture anchor repair for conventional tendon to bone type tears. This surgical technique reduces risk of overtensioning the repair and optimizes the healing environment in this rare clinical scenario. Discussion/Conclusion: Side-to-side suture repair for full-thickness transtendinous supraspinatus tears is an effective treatment for patients with this uncommon presentation. When healthy tendon is present, a robust repair can be achieved with excellent outcomes and low rates of surgical complications. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.