{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T13:55:14Z","timestamp":1791554114454,"version":"4.3.4"},"reference-count":6,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["arthrosc. tech."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>An all\u2010arthroscopic rotator cuff muscle advancement technique is presented for posterosuperior massive tears. This procedure involves subperiosteal release of the supraspinatus and infraspinatus from the scapula while preserving continuity with the levator scapulae and the rhomboid muscles. Along the medial scapular border, interposed fibrous bands, termed \u201cHakusen\u201d (white lines), exist between the rotator cuff muscles and the levator scapulae\/rhomboids. The superior and inferior Hakusen are continuously connected through the periosteum of the scapular triangular area. The fibrous unit comprising the superior Hakusen, triangular\u2010area periosteum, and inferior Hakusen is defined as the Hakusen\u2010triangular area complex. Incomplete release at the medial extent of this unit may limit cuff excursion. Our technique adds targeted triangular\u2010area management and the scapular triangular view to maintain visualization of the medial scapular border and standardize the endpoint as complete sequential subperiosteal release of the Hakusen\u2010triangular area complex to its medial extent. In our cadaveric comparison, conventional release left residual triangular\u2010area periosteum, whereas this technique achieved continuous medial\u2010end release including the Hakusen. By increasing lateral excursion and reducing repair tension, this approach may facilitate low\u2010tension primary footprint repair.<\/jats:p>","DOI":"10.1002\/atn2.70301","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T13:47:56Z","timestamp":1791553676000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["All\u2010Arthroscopic Rotator Cuff Muscle Advancement With Pan Scapular Release and Using the Scapular Triangular View"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6162-0307","authenticated-orcid":false,"given":"Hiroaki","family":"Moriyama","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Kurume University Medical Center Hospital  Kurume, Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Gotoh","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Kurume University Medical Center Hospital  Kurume, Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7170-5401","authenticated-orcid":false,"given":"Hiroki","family":"Ohzono","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Kurume University Medical Center Hospital  Kurume, Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Mitsui","sequence":"additional","affiliation":[{"name":"Hyakutake Orthopedic Clinic  Saga\u2010shi Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7798-8381","authenticated-orcid":false,"given":"Kosuke","family":"Tabuchi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Kurume University Medical Center Hospital  Kurume, Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Hiraoka","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Kurume University  Kurume\u2010shi Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Okawa","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Kurume University Medical Center Hospital  Kurume, Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.jseint.2024.11.011","article-title":"Clinical outcomes of primary repair for large and massive rotator cuff tears using an all\u2010arthroscopic rotator cuff muscle advancement technique","volume":"9","author":"Morihara T","year":"2024","journal-title":"JSES Int"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"2812","DOI":"10.1016\/j.arthro.2024.07.014","article-title":"Editorial commentary: Muscle advancement, footprint medialization, and repair medialization could improve healing and clinical outcomes of massive rotator cuff tears as a result of low\u2010tension repair","volume":"40","author":"Hartzler RU","year":"2024","journal-title":"Arthroscopy"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"2801","DOI":"10.1016\/j.arthro.2024.03.041","article-title":"All\u2010arthroscopic supraspinatus and infraspinatus muscle advancement leads to high healing rate and excellent outcomes in patients with massive, retracted rotator cuff tears, even in patients with pseudoparalysis","volume":"40","author":"Gupta A","year":"2024","journal-title":"Arthroscopy"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"151938","DOI":"10.1016\/j.aanat.2022.151938","article-title":"Levator scapulae and rhomboid minor are united","volume":"243","author":"Kulow C","year":"2022","journal-title":"Ann Anat"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"e1439","DOI":"10.1016\/j.eats.2021.02.009","article-title":"All\u2010arthroscopic muscle slide and advancement technique to repair massive retracted posterosuperior rotator cuff tears","volume":"10","author":"Gupta A","year":"2021","journal-title":"Arthrosc Tech"},{"key":"e_1_2_7_7_1","first-page":"232596712412660","article-title":"Muscle advancement during arthroscopic rotator cuff repair as a treatment option for irreparable rotator cuff tears","volume":"12","author":"Oh SY","year":"2024","journal-title":"Orthop J Sports Med"}],"container-title":["Arthroscopy 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