This is considered a “massive” rotator cuff tear, where the supraspinatus and infraspinatus tendons have retracted back to the equator of the glenoid. In this photo, the supraspintus tendon should be attached on the greater tuberosity of the humeral head (well-beyond the red star).
Arthroscopic fixation required 3 medial (inner) row anchors (12 sutures total) and 2 lateral (outer) row anchors. The anchors are buried in the bone and then the sutures from the anchors are passed through the rotator cuff tendon. When pulling on the sutures, the cuff tendon advances to its native attachment site at the greater tuberosity.
As compared to the first photo, the rotator cuff tendon is now covering the great tuberosity and shoulder joint. As we say “the shoulder does not take a joke very well” and this patient will have a long recovery ahead. Patients typically have deep, achy pain for several weeks after surgery and sleep disturbance is the #1 complaint as most prefer sleeping in a semi-reclined position or even in a reclining chair!