Arthroscopic repair has gained popularity as the first-line technique for repairing not only smalland medium-sized rotator cuff tears, but large and massive tears as well. An all-arthroscopic technique is less damaging to the overlying deltoid muscle than are open or mini-open techniques. In addition, an allarthroscopic technique provides greater versatility in terms of characterizing, accessing, mobilizing, and fixing the torn rotator cuff tendon. Arthroscopic rotator cuff repair allows complete evaluation of the intra-articular and bursal anatomy while causing minimal morbidity in terms of postoperative pain and scarring.

Because the arthroscopic technique may at first seem complex and time-consuming, making the transition from open to arthroscopic repair can be difficult. As with most surgical procedures, however, practice and an organized approach can make even many of the largest tears amenable to arthroscopic repair. We outline our stepwise technique for arthroscopic repair of full-thickness rotator cuff tears (using triple-loaded suture anchors) and report the key steps necessary for maximizing efficiency and reproducibility.