Semitendinosus Allograft Anterior Cable Reconstruction for Irreparable Rotator Cuff Tears Utilizing the Superior Glenoid Margin for Glenoid Fixation

For large posterosuperior rotator cuff tears with irreparable combined supraspinatus and partial infraspinatus tears, anterior cable reconstruction (ACR) using allograft tendon can restore superior stability and reduce subacromial contact pressures without limiting motion. ACR was originally performed using rigid glenoid neck anchors, but superior glenoid margin fixation with knotless all-suture soft anchors may improve technical efficiency. This Technical Note describes the surgical indications and technique for a labral-based ACR using a semitendinosus allograft for large-to-massive rotator cuff defects without needing a Neviaser portal.