Fig. 2A-H These images illustrate the surgical steps of the typical anchorless transosseous approach to repair of a torn rotator cuff. (A) A bone punch was used at the desired anchor site in the greater tuberosity (arrow), (B) and a tunneling device was inserted into the pilot hole (arrow). (C) An awl was passed through the lateral cortex using the tunneling device (long arrow) after a capture device was inserted into the pilot hole (short arrow). (D) The tunneling device was removed and a passing suture was captured by the tunneling device and passed through the tunnel. (E) Repair sutures were passed through the passing loop as shown by the arrow. (F) The sutures were passed through the torn rotator cuff tendon. (G) The sutures were then tied together over the top of the cuff. (H) This image is a coronal cross-section of the tunneled transosseous cuff repair. Illustration: Tim Phelps, MS, FAMI, © (2016) JHU AAM Department of Art as Applied to Medicine, The Johns Hopkins University School of Medicine.