Rotator Cuff Tears: Cable Reconstruction

Rotator Cuff Tears: Cable Reconstruction

This surgical video demonstrates a cable reconstruction for the treatment of a massive irreparable rotator cuff tear. The rotator cable is a thick, semicircular band of tissue that helps connect some of the rotator cuff tendons to the humerus, or upper arm bone, and distributes forces between the tendons.

When a rotator cuff tear is so large that it cannot be repaired, a cable reconstruction can be performed. This procedure uses suture to reinforce the detached portion of the torn tendon and anchors to re-establish the rotator cable attachments back to the upper arm bone.

Here, we see an inside view of a left shoulder from an arthroscopic camera. The camera is looking at the top of the shoulder, with the front of the shoulder at the top of the screen and the back of the shoulder at the bottom of the screen.

Here, you can see a large U-shaped rotator cuff tear that cannot be repaired. Most of the tendon has torn off from the upper arm bone with only a small portion of the tendon still attached at the front and back of the shoulder. Sutures have already been placed through the tendon at the back of the shoulder and secured into the upper arm bone with an anchor.

From here, the surgeon continues using a long suture strand to pass through the detached portion of the tendon from back to front for reinforcement. Next, the surgeon makes a socket into the front of the upper arm bone and inserts an anchor to tack down the suture and tendon. The sutures are then cut off.

The cable reconstruction is complete. Here, you can see the finished product, with the front and back attachments of the tendon secured to the rotator cable and upper arm bone.