The Tension-band Suture Technique for Arthroscopic Rotator Cuff Repair

New suture methods and ''double-row'' fixation are advocated as means to improve the contact surface area and pressure at the tendon-bone interface, thereby increasing the success rate of arthroscopic cuff repair. By combining a medially placed inverted horizontal mattress suture with a laterally placed anchor, the ''tension-band suture'' offers the same benefits without potential disadvantages: (1) it allows the surgeon to perform a true decortication of the bone, without potential compromise of anchor security; (2) it minimizes anchor ''pullout,'' as the vector of tendon pull is 90 degrees to the direction of the anchor; (3) it accommodates a large repair site at the native insertion of the supraspinatus because the tendon is pulled laterally toward the tendon bed; (4) the inverted horizontal mattress configuration of the sutures maximizes surface area contact of the tendon to the bone, compressing the repaired tendon against the footprint; (5) the technique is simple to perform, with no requirement for additional specialized instruments or additional procedures, thus reducing operative time. We report on our experience with a "tension-band'' suturing technique for arthroscopic cuff repair.