Sutures Configurations

Single Tunnel: Double Tunnel
  • Claudio Chillemi
  • Alessandro Castagna
  • Marcello Osimani


Arthroscopic surgery takes the lessons of conventional open surgery and allows these to be performed in a minimally invasive manner (White et al. 2006). Shoulder surgeons surely understand the complexity and pitfalls of arthroscopic rotator cuff repair. Starting from the initial fixation, the surgeon must construct a strong chain that consists of bone, suture material, suture configuration, and arthroscopic knot (Gerber et al. 1994) and that will withstand the loads imposed upon it during biological healing (Schneeberger et al. 2002). Moreover, in the presence of “soft” porotic bone, it is advisable to augment it so to avoid any cutout. Taking into considerations the transosseous technique to repair a rotator cuff tear, once evaluated and accurately prepared both the tendinous (size, quality, retraction, and pattern of the tear) and bony (porosis, cyst, presence of devices such as anchors employed in previous surgery) side of the lesion, the surgeon is able to plan how it is possible “to close the hole,” following what is established in the flow chart reported below (Fig. 8.1).

Supplementary material

Video 8.1

Pure transosseous technique (MP4 179233 kb)

Video 8.2

8-shape technique (MP4 128293 kb)

Video 8.3

2 MC technique (MP4 147683 kb)

Video 8.4

2 C technique (MP4 154491 kb)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Claudio Chillemi
    • 1
  • Alessandro Castagna
    • 2
  • Marcello Osimani
    • 3
  1. 1.Department of Orthopaedics and TraumatologyIstituto Chirurgico Ortopedico Traumatologico (ICOT)LatinaItaly
  2. 2.Shoulder UnitIstituto Clinico HumanitasMilanItaly
  3. 3.Department of Radiological Sciences, Oncology and Pathology“Sapienza” - University of Rome (ICOT Latina)RomeItaly

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