# Combined Biceps Anterior Cable Reconstruction and Biological Tuberoplasty for Irreparable Rotator Cuff Tears Using a Composite Collagen Matrix–Achilles Tendon Allograft

## TL;DR

A new surgical technique combines biceps reconstruction and biological tuberoplasty to treat severe shoulder injuries, improving joint stability and function.

## Contribution

The novel contribution is combining biceps anterior cable reconstruction with biological tuberoplasty using a composite collagen matrix–Achilles tendon allograft.

## Key findings

- The combined approach stabilizes the humeral head and prevents bone contact during shoulder movement.
- This technique promotes joint preservation and improves postoperative pain and shoulder function.
- Biological tuberoplasty provides cushioning to avoid acromion and greater tuberosity abutment.

## Abstract

This article describes a technique that combines biceps anterior cable reconstruction with biological tuberoplasty using a composite collagen matrix–Achilles tendon allograft for patients with irreparable rotator cuff tears. These patients often experience loss of the force couple, leading to superior humeral migration, which causes an abutment of the greater tuberosity against the acromion during active deltoid contraction. In addressing this issue, both biceps anterior cable reconstruction and biological tuberoplasty have proved effective. The combined approach offers biomechanical advantages by stabilizing the humeral head through biceps anterior cable reconstruction while biological tuberoplasty provides cushioning and prevents bone-to-bone contact between the acromion and greater tuberosity. We believe these 2 procedures have a synergistic effect, promoting joint preservation, postoperative pain relief, and improved shoulder function.