Anterior Cable Reconstruction Using Semitendinosus Allograft for Large Rotator Cuff Defects

For large posterosuperior rotator cuff tears where the footprint cannot be completely restored due to retraction or tissue loss, anterior cable reconstruction using autologous proximal long head of the biceps tendon has been shown to biomechanically limit superior migration and subacromial contact pressures without inhibiting range of motion. In the setting where an autologous proximal long head of the biceps tendon is deficient or absent, anterior cable reconstruction with the use of a semitendinosus allograft has been shown to provide an equivalent level of biomechanical effectiveness. The purpose of this Technical Note is to reveal and describe the surgical indications and technique for an anterior cable reconstruction using a semitendinosus allograft for large rotator cuff defects.