A Simple Knot Technique to Simultaneously Prevent Medial‐Row Suture Loosening and Lateral‐Row Anchor Failure in Double‐Row Rotator Cuff Repair

We describe a simple knot‐tying technique to augment fixation during double‐row rotator cuff repair. After standard lateral‐row anchor placement and suture tensioning, the remaining suture limbs are secured with a surgeon's knot positioned flush against the bone‐anchor interface. This knot serves as a mechanical stopper: when the retracted cuff exerts medial traction on the medial‐row sutures, the knot blocks suture slippage at the lateral bone surface, generating a counterforce that neutralizes pullout forces and maintains footprint compression. No additional implants are required. This technique is particularly valuable in osteoporotic bone or massive cuff tears, where lateral‐row anchor fixation is prone to early failure.