This is the first monograph dedicated exclusively to transosseous technology and the first book supported by the Transosseous Academy.

The book covers all of the aspects from etiopathogenesis and classification to imaging, from the rationale of supporting the use of transosseous to an extensive comparison between various repair techniques.
An historical background is covered together with an updated description of the features of the most recent arthroscopic devices used to repair the cuff using a transosseous approach. In the second half of the book, surgical indications and suggested rehabilitation protocols are provided.

In the last part, economical aspects are addressed.

The authors are well recognized in the international shoulder arena and share their extensive clinical experience about transosseous. With a forward by Prof. Gigante and Dr. S. Snyder this is a must have guide for anyone wanting to know more about and adopt what is still considered the gold standard in rotator cuff repair (RCR).

This “hot” and interesting topic (superior capsular reconstruction) as proposed in this article shows a completely new and original way of making use of the transosseous approach. Today, SCR is considered a technically demanding and expensive procedure, because of the cost of the allograft and the anchors used to fix it. The Arthroscopic Biceps Chillemi’s technique addresses these concerns in performing SCR while presenting numerous advantages including it being a safe, easy, time and cost-saving way compared to the other published techniques. This technique has only one conditional sine qua non: the presence of the long head of the biceps tendon (LHB), used as an autograft. This condition may be interpreted as a disadvantage in the presence of some anatomic variations of the intra-articular portion of the LHB and the very rare absence of the tendon or in case of partial or complete rupture of the LHB tendon associated with a rotator cuff tear.

The authors show an easy, reproducible and cost effective way to repair the cuff with a transosseous technique. The authors present a preliminary case series with a minimum follow up of 12 months.
The technique consists of the use of parallel tunnels and a unique suture tape that goes across them creating a large mattress effect and a stable tying on the lateral cortical bone.

This paper is about the measurement of the gap formation as a key predictor of repair performance. The rotator cuff repair (RCR) is stressed in a dynamic way allowing the time-zero-repair to be maintained over time. Some geometrical and environmental variables are addressed in the paper affecting the efficacy of the repair. In particular, tunnel shape and bone quality are discussed as well as its influence on the repair performance as evaluated in a biomechanical lab set up.

This biomechanical testing suggests that arthroscopic, Xbox transosseous rotator cuff repair is similar in strength and stability to an arthroscopic transosseous equivalent, suture-bridge repair using suture anchors. It has a potentially lower cost. Both techniques had difficulty maintaining the position of the lateral edge of the tendon.