Arthroscopic 4-Anchor Double-Pulley Suture-Bridge Repair of Large Rotator Cuff Tear.

Huang, Peiguan; Wang, Xiaoxu; Fu, Yong; Tang, Xiaojun; Xiao, Zhihong; Li, Zhengmao; He, Chunrong · Arthrosc Tech · 2025

expert_opinion · Level V

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Abstract

Currently, suture bridge (SB) is a popular way to treat large rotator cuff tears. However, the restricted number of sutures used for tendon fixation, the knotted medial row, and the excessive number of tendon holes created from suture hook piercing are the shortcomings of SB repair. Arthroscopic 4-anchor double-pulley suture-bridge (DPSB) repair is a pragmatic surgical technique and can overcome these shortcomings of SB repair. In the repair of large rotator cuff tears with the 4-anchor DPSB technique, 8 sets of DPSBs can obtain powerful fixation strength on the tendon, and sufficient tendon-to-bone coverage area, a knotless medial row, and only 4 tendon holes created from suture hook piercing can reduce the type 2 retear rate.

Anatomy