A Transosseous Suture Technique for Rotator Cuff Repair in Patients With Severe Osteoporosis

Abstract Suture anchor‐based repair is widely regarded as the standard technique for rotator cuff tears; however, in patients with severe osteoporosis, anchor pullout remains a major concern. Classical transosseous rotator cuff repair provides favorable biomechanical strength and avoids anchor‐related complications but has several inherent limitations. We describe a transosseous rotator cuff repair technique that simulates the function of the medial‐row anchor in anchor‐based repair, specifically for rotator cuff tears associated with severe osteoporosis. This technique combines favorable biomechanical performance with a straightforward surgical procedure, a flexible suture configuration, and a relatively low risk of complications and may serve as an effective alternative for rotator cuff repair in patients with compromised bone quality.