Table 1: Advantages and disadvantages of the ATOT technique.

Advantages

Disadvantages

Cost-effective, eliminates the cost of using anchors

Technically demanding at the beginning due to the learning curve (like any surgical technique)

Improved rotator cuff

footprint biology

Requires use of

a new device

Possibility of evaluating the rotator cuff completely in follow-up with MRI

Less postoperative pain

Possibility of creating multiple attachment points, more efficient load distribution and reduced stress on tissues

Synergy, hybrid constructs possible (they are not mutually exclusive)

Type 1 failure check much simpler

ATOT = arthroscopic transosseous tunnel.

MRI = magnetic resonance imaging.