A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears

Rotator cuff tears remain one of the most common injuries encountered by shoulder surgeons. Although arthroscopic suture-bridge repair has demonstrated superior biomechanical properties and achieved promising clinical results, tendon retears remain a persistent challenge. To address this issue, we have introduced several refinements to optimize the existing repair techniques. One such refinement is the incorporation of a medial knot in the suture-bridge repair, which can decrease gap formation and enable a watertight repair, thereby improving tendon-bone healing. Another critical modification is the use of a rip-stop configuration in the medial row, which can reduce potential suture cut-out, strengthen the resistance of the suture-tendon interface, and lower the risk of type II retear. Therefore, we propose a novel hybrid repair technique that integrates medial knot-tying suture-bridge repair and rip-stop configuration into a single construct. Additionally, this new repair technique offers the benefit of reducing the number of suture passages and suture anchors required, thereby streamlining the repair process. In summary, this method represents a viable and effective alternative for the treatment of rotator cuff tears and may contribute to reducing the incidence of postoperative retears.