Table 2.

Pearls and Pitfalls

Pearls

•The antegrade suture passer is used in an unconventional manner to place the luggage tag type sutures. This can be performed efficiently and effectively. An alternative is to use a penetrating grasper to unload suture on one side and retrieve on the other side of the LHBT for the loop followed by penetrating the tendon for the tack stitch.

•The suture anchor can be placed through the anterior or anterolateral portal based on optimal perpendicular trajectory to the bicipital groove.

Pitfalls

•Hold tension on the Prolene sutures to reduce the risk of inadvertently cutting them with the shaver during subacromial bursectomy. An alternative is to use spinal needles to mark the LHBT intra-articularly and leave them in place during subacromial bursectomy.

•Soft tissue swelling in the subacromial space may occlude visualization. This technique is recommended to be performed after acromioplasty if indicated but before rotator cuff repair in the subacromial space.