Irreparable rotator cuff tears remain a challenging condition to manage surgically, particularly in young and active patients without significant glenohumeral osteoarthritis. Several solutions have been proposed, and more recently, superior capsular reconstruction using the long head of the biceps tendon has shown promising results using an easily accessible autograft. In the present article, we describe an arthroscopic technique in which the long head of the biceps tendon is rerouted onto the greater tuberosity using knotless anchors for fixation of the tendon to greater tuberosity. This technique allows the stable long head of the biceps tendon compression to the bone and easy incorporation of the posterior cuff, resulting in a simple surgical construct. The advantage of this technique is the use of knotless anchors, which allows for fast, versatile, and bony-preserving fixation technique.

Large to massive rotator cuff tears are frequently associated with poor tendon quality and high rates of structural failure after repair. Acellular human dermal matrix patch augmentation combined with rotator cuff repair has been introduced to enhance bone-to-tendon healing by providing early postoperative mechanical strength. However, fully arthroscopic patch augmentation techniques are technically demanding and associated with increased operative complexity. The described technique combines arthroscopic evaluation and subacromial decompression with an anterolateral miniopen triple-row repair and onlay acellular human dermal matrix patch augmentation. This approach simplifies patch handling while providing strong fixation and may represent a practical alternative to fully arthroscopic patch augmentation techniques.

Partial rotator cuff tears present a common clinical challenge, and optimal management remains debated. This technical note describes an arthroscopic margin convergence repair technique performed without the use of suture anchors for patients with partial-thickness rotator cuff tears. The technique is applicable for partial-thickness tears of varying configurations, including longitudinal, horizontal, and complex tear patterns. The procedure preserves the native tendon footprint and minimizes disruption of healthy tissue while restoring the rotator cuff's biomechanical continuity. With the patient in the beach-chair position, standard posterior and anterosuperior portals are used to access both articular and bursal aspects of the tear. Suture passage is performed side-to-side using a nonlocking loop configuration to achieve tension-free convergence. This approach avoids hardware complications, reduces cost, and allows accelerated rehabilitation by maintaining anatomic integrity. This technique is particularly suitable for high-grade partial rotator cuff tears that fail conservative treatment.