A Simple Knot Technique to Simultaneously Prevent Medial‐Row Suture Loosening and Lateral‐Row Anchor Failure in Double‐Row Rotator Cuff Repair

We describe a simple knot-tying technique to augment fixation during double-row rotator cuff repair. After standard lateral-row anchor placement and suture tensioning, the remaining suture limbs are secured with a surgeon's knot positioned flush against the bone-anchor interface. This knot serves as a mechanical stopper: when the retracted cuff exerts medial traction on the medial-row sutures, the knot blocks suture slippage at the lateral bone surface, generating a counterforce that neutralizes pullout forces and maintains footprint compression. No additional implants are required. This technique is particularly valuable in osteoporotic bone or massive cuff tears, where lateral-row anchor fixation is prone to early failure.