A, Arthroscopic subacromial view of massive retracted cuff tear and biceps in lower corner. Humeral tuberosity is to right. B, Placement of starting hole for medial anchor. Note 45-degree angle to shaft and placement 2 mm off articular edge. C, Use of Scorpion to place mattress suture 16 mm medial to torn edge. D, Completion of medial mattress suture placement and storage in cannula. Sutures can be used to pull tendon to its tuberosity to help identify appropriate placement of lateral anchors and sutures. E, Completed double-row repair with cuff securely repaired to anatomic footprint.