Combined Biceps Anterior Cable Reconstruction and Biological Tuberoplasty for Irreparable Rotator Cuff Tears Using a Composite Collagen Matrix–Achilles Tendon Allograft

This article describes a technique that combines biceps anterior cable reconstruction with biological tuberoplasty using a composite collagen matrix-Achilles tendon allograft for patients with irreparable rotator cuff tears. These patients often experience loss of the force couple, leading to superior humeral migration, which causes an abutment of the greater tuberosity against the acromion during active deltoid contraction. In addressing this issue, both biceps anterior cable reconstruction and biological tuberoplasty have proved effective. The combined approach offers biomechanical advantages by stabilizing the humeral head through biceps anterior cable reconstruction while biological tuberoplasty provides cushioning and prevents bone-to-bone contact between the acromion and greater tuberosity. We believe these 2 procedures have a synergistic effect, promoting joint preservation, postoperative pain relief, and improved shoulder function.