How often does suture “Over-Tightening” or “Under-Tightening” occur during rotator cuff repair surgery? Is there a benefit to controlling suture tension?

Over-Tightening happens when sutures are pulled too tightly, leading to excessive tension on the tissue, restricted blood flow, impaired healing, and potential tissue failure. Can this limit shoulder movement post-surgery and cause stiffness?

Under-Tightening occurs when sutures aren’t tight enough, risking an unstable repair. Could this result in poor healing, persistent weakness, or pain in the shoulder?

The PHANTOM-LP™ is the first and only knotless 100% PEEK anchor that allows for suture tension adjustment after the anchor is fully inserted. Dr. Matthew Ramsey explains how he uses the PHANTOM-LP™ locking mechanism to adjust suture tension after insertion, as demonstrated in the video.

Why expose rotator cuff tears to over- or under-tightening when it can be avoided? Comments are welcome—it’s how we learn and refine our skills.