Krackow Stitch Augmentation for Arthroscopic Rotator Cuff Repair: Surgical Technique

Despite the advances in arthroscopic rotator cuff repair, postoperative structural failure remains a persistent problem. Retear patterns are commonly classified as type 1 failure, which is associated with the poor quality of the torn tendon edge, and type 2 failure, which occurs at the medial suture site owing to stress concentration within the repaired tendon. Consequently, we propose an arthroscopic medial augmentation technique using a suture tape‐based Krackow construct placed medial to the footprint as an adjunct to conventional rotator cuff repair. By obtaining additional fixation in more medial tendon tissue, this technique may reduce dependence on a compromised tendon stump and may also help distribute the load away from the medial suture site. This Technical Note describes the surgical details of this augmentation method that is intended to provide additional tendon reinforcement and load sharing without altering the surgeon's preferred primary repair configuration.