The “Parachute” Technique: A Simple and Effective Single-Row Procedure to Achieve an Increased Contact Area Between the Cuff-Tendon and Its Footprint

Many techniques of arthroscopic rotator cuff repair have been described. No significant differences in clinical outcomes or rerupture rates have been observed when comparing single-row with double-row methods. Not all single- and double-row repairs are the same. The details of the technique used are crucial. It has been shown that the suture-tendon interface is the weakest point of the reconstruction. Therefore, the biomechanical properties of rotator cuff repairs might be influenced more by the suture configuration than by the number of anchors or by the number of rows involved. Techniques that secure less amount of tendon over a smaller area of the healing zone might be expected to have higher failure rates. The way the sutures of the "parachute technique" are configured represents a quadruple mattress that increases the contact and pressure between the tendon and its footprint and increases the primary load to failure of the repair. We present a simple and effective single-row technique that involves the biomechanical and biological advantages related to the increased contact area and pressure between the cuff and its footprint.