Arthroscopic Biologic Tuberoplasty With Cable Reconstruction: A Technique for Massive Irreparable Rotator Cuff Tears

Massive irreparable rotator cuff tears present a significant challenge in shoulder pathology, particularly for patients who are not suitable candidates for arthroplasty. Such tears disrupt the mechanical function of the shoulder joint, leading to progressive deterioration of the glenohumeral joint cartilage and the eventual development of rotator cuff arthropathy. Patients typically exhibit pain and a decline in functional capacity, subsequently facing the difficult task of selecting from a multitude of available treatment options. Among these options, arthroscopic biologic tuberoplasty has shown satisfactory clinical outcomes alongside a low rate of reoperation. In addition, the rotator cuff cable, a critical anatomical structure within the shoulder, has been identified as a significant contributor to glenohumeral joint stability. The preservation of the rotator cuff cable's integrity is vital for maintaining function and alleviating strain on the remaining rotator cuff tissue. Consequently, we propose an enhancement to our previous technique of biologic tuberoplasty, which now encompasses anterior/posterior medial cable reconstruction.