# Arthroscopic Suture Bridge Combined All-Inside Fixation for Delaminated Rotator Cuff Tears

## TL;DR

This paper introduces a new arthroscopic technique for repairing complex rotator cuff tears by combining two methods to improve surgical outcomes.

## Contribution

A novel arthroscopic technique combining suture bridge and all-inside fixation for delaminated rotator cuff tears is presented.

## Key findings

- The technique decouples outer tear size from lower-layer repair limitations.
- Accurate tear identification and preoperative planning are critical for success.
- The method is suitable for small, deep-layer dominant delaminated tears.

## Abstract

The anatomic repair of delaminated rotator cuff tears presents a surgical challenge, necessitating innovative solutions for optimal outcomes. This Technical Note describes the arthroscopic suture bridge combined with all-inside fixation, a novel approach tailored for small yet deep-layer dominant delaminated tears. The method involves addressing the upper-layer tear beneath the acromion and employing all-inside suturing in the glenohumeral joint for the lower-layer tear, decoupling the outer tear size from limiting the treatment of the deeper tear. Accurate tear identification and preoperative planning are critical for success. This technique offers advantages in overcoming the outer tear’s impact on lower tear repair, potentially reducing patient costs. Proficiency in tear identification and surgical planning is essential for successful execution. Considerations include reserving sutures as a precaution and inapplicability to posteriorly located delaminated tears. This approach provides a valuable contribution to arthroscopic techniques, especially for smaller delaminated tears.