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Tears of the rotator cuff are a frequent pathology, but the best surgical procedure remains unclear. The arthroscopic approach has become the gold standard, but there are many different suture configurations that can be used. We describe an all-suture repair system with which the anatomical reduction of the rotator cuff is achieved performing traction from the anchor of the lateral row to subsequently performing a suture bridge suture from the medial row. The major advantage of this technique is that it creates compression forces and minimizing tensioning of the tissue.

Posterior shoulder instability is commonly missed as a cause of shoulder dysfunction, due to the fact that clinical symptoms may differ from those found in anterior instability. Microtraumas produced by repetitive gestures cause progressive injury of the posterior stabilizers of the joint, causing mostly pain. It is crucial to identify the etiology and the clinical pattern to decide the correct treatment.

Rotator cuff re-tears are true challenges for shoulder surgeons. Several treatment options exist and its choice should be individualized depending on patient characteristics. It is crucial to identify the reason why the cuff re-tears. When there is no intense atrophy or fatty degeneration and exists a reasonable potential of healing of the tendon, a revision repair can be attempted. It is important to optimize the surgical technique to obtain a stable, tension-free repair in order to favor good outcomes.