13 All-Arthroscopic Anchorless Transosseous Rotator Cuff Repair

Aydin Budeyri, Raffaele Garofalo, and Sumant ?Butch? Krishnan


Open transosseous rotator cuff repair was traditionally the gold standard technique for repair of the torn rotator cuff. All-arthroscopic transosseous (anchorless) rotator cuff repair is an exciting breakthrough over the last decade that combines the advantages of open techniques with a minimally invasive approach. It offers simple, biomechanically reliable, and anatomic tendon-to-bone healing. This all-arthroscopic anchorless approach also uniquely preserves bone tuberosity if a revision procedure ever becomes necessary.

Keywords: all-arthroscopic rotator cuff repair, anchorless, rotator cuff tear, transosseous

13.1 Case and Scope

The case and the scope of this chapter demonstrates a step-by-step instructional video guide (? Video 13.1) featuring the senior author?s novel all-arthroscopic anchorless transosseous rotator cuff repair technique. The presented case specifically highlights key elements for a combined supraspinatus and anterior infraspinatus ?L?-shaped complete tendon tear.

Chapter sections are the history, physical examination findings, preoperative radiologic findings, operative planning, patient positioning, preoperative work-up and equipments, intraoperative findings, technical steps, tips and pearls, postoperative period, physical therapy and rehabilitation, final functional status of the patient, and scientific evidence.1


Video 13.1 Surgical demonstration of an all-arthroscopic transosseous rotator cuff repair.


[1] Flanagin BA, Garofalo R, Lo EY, et al. Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair. Int J Shoulder Surg. 2016; 10(1):3?9

Suggested References

Post M, Silver R, Singh M. Rotator cuff tear: Diagnosis and treatment. Clin OrthopRelat Res. 1983(173):78?91

Ramsey ML, Getz CL, Parsons BO. What?s new in shoulder and elbow surgery. J Bone Joint Surg Am. 2010; 92(4): 1047?1061

Garofalo R, Castagna A, Borroni M, Krishnan SG. Arthroscopic transosseous (anchorless) rotator cuff repair. Knee Surg Sports TraumatolArthrosc. 2012; 20(6):1031?1035