Arthroscopic Repair of Rare Transtendinous Rotator Cuff Tear: Utilizing Established Portals and a Posterior Superior Accessory Portal

Abstract

There is a high incidence of rotator cuff injuries in the adult population, and there are well-described techniques for the most common types. Full-thickness transtendon rotator cuff tears are an uncommon injury, and there is limited literature on the appropriate treatment. These rare injuries are important to recognize due to the risk of repair failure using traditional techniques. Simply anchoring the medial portion of the tendon to the anatomic footprint after debriding the lateral tendon risks overtensioning the tendon. Previous techniques share the problem of poor visualization and difficulty passing sutures from standard portals. This technique uses 2 portals, the well-described Neviaser portal and a posterior superior accessory portal. Through these 2 portals, the goal is to increase visualization, increase ease of passing sutures, and avoid debridement of intact tendon.