Suture-bridge subscapularis tendon repair technique using low anterior portals.

A suture-bridge technique has been introduced to facilitate fixation procedures and to achieve increased holding strength in posterosuperior rotator cuff. Based on biomechanical studies, this technique has been suggested as an effective method that could optimize rotator cuff tendon-footprint contact area and mean pressure, as well as holding strength. In this technique, the suture-bridge creation is adapted for arthroscopic subscapularis repair to attain the ideal cuff integrity and footprint restoration. To obtain enough working portals and space, two accessory portals were made on the anterior aspect of the shoulder and use an elevator to retract the conjoined tendons and deltoid muscle. This technique could be useful for the repair of subscapularis tears, which are not easily approached using other arthroscopic techniques. From a biomechanical point of view, the subscapularis tendon could be restored more ideally using the suture-bridge technique.