In this type of reconstruction, the cap of the rotator tendon is mobilised and reinserted in the bone. Since this always increases the tension in the freshly operated tissue, patients experience greater pain for a short period immediately after their operation.

A cushioned abduction splint has to be worn to relieve the pain. When operating on the RC, I generally also "widen the roof" by enlarging the acromial angle (see section on lift-up osteotomies of the acromion).

The AC joint is also trimmed back in order to avoid pain from this small joint after the operation. This widening of the "subacromial space" is necessary to provide sufficient room for the reconstructed RC and prevent further chafing of the cuff. The rest of the bursa between the acromion and the RC is also usually removed during this procedure, firstly because the bursa also tends to be injured as a result of the RC tear, and secondly because it is restored spontaneously within 6 months as a result of intensive post-operation physiotherapy

direct, simple reinsertion