Six surgical steps demonstrate an open repair of a right rotator cuff tear. Bursitis, an arthritic acromioclavicular joint, and a retracted rotator cuff tear were found upon examination. An acromioplasty and bursectomy were then performed. A trough was made in the humeral head to implant suture anchors. Fastin sutures then secured the rotator cuff to the humerus via the anchors.