Dr. Garcia’s cutting edge rotator cuff repair technique (one of the first videos of the new Arthrex knotless swivelock).

This video demonstrates an advanced arthroscopic technique for a fully knotless, double-row rotator cuff repair on a patient with a large tear involving the supraspinatus and part of the infraspinatus tendon. By using specialized knotless anchors, the procedure achieves uniform compression across the bone footprint without the need for bulky, irritating knots.

The repair is executed through the following clinical steps:

• Footprint Preparation: The procedure begins with debridement of the damaged bursa and frayed tendon margins. Dr. Garcia performs a light decortication (scraping) of the greater tuberosity to create a raw, bleeding bone bed, which releases natural growth factors to accelerate tendon healing.
• Medial Row Anchor Placement: Two 4.75 mm knotless SwiveLock anchors are inserted along the inner margin of the bone footprint near the articular cartilage to establish a broad structural foundation.
• Suture Passing & Cinching: Using an arthroscopic Scorpion needle and a flexible FiberLink loop, heavy FiberTapes and anchor sutures are driven through the torn tendon. Dr. Garcia engages the built-in knotless eyelet function of the anchors, sequentially pulling the loop stitches back and forth. This draws the tendon edge flat against the bone bed in a highly compressed horizontal mattress layout.
• Lateral Row Crisscross Fixation: To complete the double-row construct, the suture tails from the medial row are gathered, tensioned, and split. They are crisscrossed diagonally over the top of the tendon to securely flatten out any bunched-up tissue edges. These strands are locked into the lateral ridge of the bone using two additional 4.75 mm SwiveLock anchors.

Once the excess suture lines are cleanly trimmed, the final evaluation shows a low-profile, high-strength "bridged" repair that maximizes tissue-to-bone contact area for optimized biological healing.