Dr. Dold now uses the TENDON SEAM™ Repair System for rotator cuff repair. It is a new way of attaching a torn rotator cuff tendon back to the bone. Instead of holding the tendon down at a few points with larger anchors and many separate sutures, it sews the tendon to the bone with a continuous “seam” of many small, individually locked stitches.
- FDA 510(k) cleared in 2023 for reattaching soft tissue, such as tendons, to bone
- Developed by Integrity Orthopaedics; Smith+Nephew acquired the company in early 2026
- One continuous suture and a series of small 2 x 10 mm PEEK micro-anchors, each tensioned and locked on its own
- Knotless, and done arthroscopically through small incisions
- Designed to spread the load across many fixation points
Why a new way to repair the rotator cuff?
The hardest part of rotator cuff surgery is not putting the tendon back; it is getting it to stay there and heal to the bone. In a large review, about 1 in 4 repairs showed a re-tear on later imaging. Re-tears are more likely with larger tears, older age, poorer tendon quality and smoking. Part of the challenge is mechanical: in a standard repair, the pull of the muscle is concentrated where a few sutures pass through the tendon, and that is where weakened tendon can pull through.
How TENDON SEAM works
Think of how a seatbelt is sewn to its buckle: many stitches share the load, so no single stitch takes all of the force. TENDON SEAM applies the same idea to the shoulder.
- One all-in-one device. A single-use instrument comes preloaded with several small PEEK anchors connected by one continuous suture.
- Stitch, anchor, lock, repeat. Dr. Dold passes the suture through the tendon and places a small toggling anchor in the bone. Each stitch is tensioned and locked on its own before he moves to the next spot.
- A seam along the footprint. The result is a chain of interconnected fixation points (the manufacturer describes 8 or more): an inner (medial) seam running across the direction of pull, and an outer (lateral) zig-zag that presses the tendon down onto the bone where it needs to heal.
- Access to healing cells. The small anchor holes are left open, which the manufacturer notes allows access to the bone marrow, the source of cells that help tendon heal to bone.
A 2026 surgical technique article in Arthroscopy Techniques describes the method: it is knotless, avoids complex suture management, can usually reach the whole tendon footprint through the standard arthroscopic portal, and aims to spread contact forces across the entire footprint to reduce stress on the tendon.
| Typical anchor-based repair | TENDON SEAM | |
|---|---|---|
| Fixation | A few larger anchors with several suture limbs | Many small micro-anchors linked by one continuous suture |
| Stitches | Passed and secured in groups | Each stitch tensioned and locked individually |
| Load sharing | Concentrated at a few points | Spread along a continuous seam |
| Knots | Depends on the technique | None |
Smith+Nephew reports the following from laboratory (biomechanical) testing and internal data, compared with a standard “transosseous-equivalent” double-row repair:
Source: Integrity Orthopaedics and Smith+Nephew data on file. These results come from laboratory testing and company reports. As of October 2026 they have not been published in a peer-reviewed clinical journal, and laboratory strength alone does not prove better healing in patients.
What we know, and what we don’t yet
- Known: the device is FDA cleared, the technique is described in the peer-reviewed literature, and the design spreads fixation across many points.
- Not yet known: long-term clinical studies comparing TENDON SEAM with standard repairs, including re-tear rates on MRI, are still to come. Early case series are reported by the manufacturer.
- True for every repair: healing depends on tear size, tendon quality, age, smoking and following the rehab plan. Individual results vary.
Is TENDON SEAM right for my tear?
Dr. Dold chooses the repair method for each patient based on the size and shape of the tear, the quality of the tendon and bone, and your goals. TENDON SEAM can be combined with other procedures when needed, such as a biceps tenodesis or a REGENETEN bioinductive implant placed over the tendon. Not every tear is suited to it, and the final decision is often made during surgery, once the tear can be seen directly.
Recovery after a TENDON SEAM repair
Because the repair is designed to share the load across many fixation points, Dr. Dold’s rehab plan after a TENDON SEAM repair is often faster than after a standard repair: patients may spend less time in the sling, start moving the shoulder sooner, and begin strengthening earlier. The exact plan depends on your tear and your healing, and you will work with a physical therapist throughout. See recovery after rotator cuff repair for the overall timeline.
Learn more about rotator cuff tears, partial-thickness tears and shoulder surgery and procedures.
Why see Dr. Dold
- Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
- Fellow of the American Orthopaedic Association (FAOA), the American Academy of Orthopaedic Surgeons (FAAOS), the American College of Surgeons (FACS) and the Royal College of Surgeons of Canada (FRCSC)
- Sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases; orthopedic residency at the University of Toronto
- Member of the International Society for Hip Arthroscopy (ISHA)
- D Magazine Best Doctors (Collin County), 2019–2026 · Rated 4.9 on Google
Frequently asked questions
What is TENDON SEAM?
TENDON SEAM is a rotator cuff repair system that sews the torn tendon back to the bone with one continuous suture and a series of small, individually locked micro-anchors, creating a “seam” of many fixation points. It is done arthroscopically through small incisions.
Is TENDON SEAM approved by the FDA?
Yes. It received FDA 510(k) clearance in 2023 for reattaching soft tissue, such as tendons, ligaments and joint capsule, to bone.
Does Dr. Dold use TENDON SEAM for every rotator cuff repair?
No. He chooses the repair method that fits your tear, based on its size and shape and the quality of the tendon and bone. The final decision is often made during surgery.
Is recovery different after a TENDON SEAM repair?
Often, yes. Because the repair spreads the load across many fixation points, Dr. Dold may allow a shorter time in the sling, earlier motion and earlier strengthening than after a standard repair, depending on your tear. Your rehab plan is set for you after surgery.
Is TENDON SEAM covered by insurance?
The device is part of the rotator cuff repair surgery. Dr. Dold accepts most major insurance plans, including Medicare and Tricare. Please call 469-850-0680 to confirm your coverage.
Sources cited on this page
- Frix JT, Serbin R, Harris HW, et al. The Tendon-to-Bone Seam: A Transtendinous Approach to Rotator Cuff Repair. Arthrosc Tech. 2026;15(8):e70093. PubMed
Technique article: a knotless, transtendinous repair using a single-use device preloaded with multiple PEEK anchors joined by one suture, creating a continuous seam of independent fixation points along the footprint. - Hein J, Reilly JM, Chae J, et al. Retear Rates After Arthroscopic Single-Row, Double-Row, and Suture Bridge Rotator Cuff Repair at a Minimum of 1 Year of Imaging Follow-up: A Systematic Review. Arthroscopy. 2015;31(11):2274-81. PubMed
Review of 2,048 repairs: double-row and suture-bridge repairs had lower re-tear rates than single-row repairs in most tear sizes. - Holtedahl R, Bøe B, Brox JI. The clinical impact of retears after repair of posterosuperior rotator cuff tears: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2023;32(6):1333-1346. PubMed
Review of 3,350 repairs: 25% were re-torn on imaging at a median of 18 months; patients with re-tears scored somewhat lower on shoulder function. - Smith+Nephew. Smith+Nephew strengthens shoulder repair portfolio with acquisition. January 12, 2026. smith-nephew.com
Acquisition of Integrity Orthopaedics; TENDON SEAM received FDA 510(k) clearance in 2023 for reattachment of soft tissue to bone. - Smith+Nephew. TENDON SEAM Repair System, product information for healthcare professionals. smith-nephew.com
Design details and manufacturer-reported laboratory data (data on file).
Same-day appointments available. Dr. Dold accepts most major insurance plans, including Medicare and Tricare. Please call 469-850-0680 to confirm your coverage.
Disclosure: Dr. Dold is a consultant for Smith+Nephew. TENDON SEAM and REGENETEN are trademarks of Smith+Nephew or its affiliates.
Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. Last reviewed October 2026. This page is general information, not medical advice.
