Suture Anchor Onlay Technique: Peroneus Longus Autograft Augmentation for Arthroscopic Irreparable Massive Rotator Cuff Tear Reconstruction.

Rotator cuff tears (RCTs) are common injuries, and treatments for irreparable massive RCTs are still controversial. Among the various treatment options for irreparable massive RCTs, rotator cuff reconstruction is considered a reasonable approach, yet there is no consensus on the optimal reconstruction technique. In this article, we introduce a suture anchor onlay technique for rotator cuff reconstruction. In our technique, the peroneus longus tendon is harvested and prepared as an autograft, and on the lateral side, a suture anchor is implanted to fix the autograft on the greater tuberosity surface. The key steps of our technique are performing anchor implantation to ensure that the autografts are fixed tightly on the greater tuberosity surface, knotting the sutures from the medial-row anchors that we pre-implanted at the midsubstance of the autograft to provide additional fixation, and finally, achieving "onlay" fixation of the autografts. Our technique can effectively reduce surgical time, simplify the reconstruction procedure, and has good clinical application value.