EMPOWER
MD Clinical Education Series
Dr. Patrick Connor
Rotator Cuff Repair & the Tendon Seam Technique
We sat down with Dr. Patrick Connor, shoulder specialist with Ortho Carolina, to review the evolution of rotator cuff repair and discuss his development of the Tendon Seam technique, a mechanized, multi-point fixation construct designed to reduce gap formation and improve healing rates. Dr. Connor outlined the historical progression of rotator cuff rehabilitation, including the six-week sling immobilization model rooted in early open repairs and variable arthroscopic fixation strength. He contrasted that with contemporary biomechanical data demonstrating significantly reduced gap formation and higher load-to-failure values with the Tendon Seam construct. His early clinical data reflects a substantially lower re-tear rate compared to the published 20–40% historical failure rates, allowing for a more progressive rehabilitation pathway in appropriately selected patients. Appropriate referrals include small to massive rotator cuff tears, revision repairs, partial-thickness tears, and cases involving compromised tissue quality, particularly in active adults seeking to minimize prolonged immobilization.
Clinic Location: OrthoCarolina – Shoulder & Elbow
Contact: Dr. Connor, Brittany Mills (Administrative Assistant), or Allison Pinkston, PA – direct communication encouraged (see internal MD contact list)
His biggest pet peeve:
Overemphasis on pure abduction and allowing patients to lead with the elbow during elevation. He emphasizes scapular plane elevation, forward flexion, and teaching patients to lead with the hand to avoid superior migration and impingement mechanics. He values therapists who individualize care and communicate promptly if progression does not align with expected healing.
Key takeaways for our team:
- Better surgical fixation strength may support earlier, controlled mobility. Most patients fall into his progressive pathway and may wean from the sling within approximately two weeks, progressing with controlled active-assisted motion while delaying strengthening until roughly three months post-operatively.
- Respect tissue biology rather than protocol dogma. Tear size, tissue quality, repair integrity, and patient-specific factors determine whether a patient follows the progressive pathway or the more traditional six-week protection model. Review the operative note and arthroscopic images to guide decision-making.
- Rehabilitation emphasis: Prioritize scapular plane elevation and forward flexion over isolated abduction. Reinforce hand-led movement patterns to reduce subacromial impingement stress.
Empower: MD Clinical Education Series
Empower is an internal clinical education series for our staff. Alan and Sydney sit down with local physicians we work with to better understand how they approach cases, when they prefer referrals, and how we can communicate more clearly and earlier in the process.
These are real conversations about surgical decision-making, injury management, and return-to-play planning. The goal is simple. Help you grow as a clinician and help us serve our patients better.
This is part of our ongoing commitment to development and investment in our team.