- AP dimension is about 25 mm and the medial-lateral dimension is 14 mm;
- the more that a repair covers and secures tendon over the healing zone, the greater the chance for tendon-bone healing;
- anatomy:
- The insertional footprint of the rotator cuff: an anatomic study
- Humeral Insertion of the Supraspinatus and Infraspinatus. New anatomical findings regarding the footprint of the rotator cuff
- Humeral insertion of the supraspinatus and infraspinatus. New anatomical findings regarding the footprint of the rotator cuff. Surgical technique.
- biologic preparation of the footprint:
- references:
- Multiple Channeling Improves the Structural Integrity of Rotator Cuff Repair
- The effect of multiple channeling on the structural integrity of repaired rotator cuff.
- Rotator cuff repair augmented with endogenous fibrin clot.
- Microfractures at the rotator cuff footprint: a randomised controlled study
- Efficacy of marrow-stimulating technique in arthroscopic rotator cuff repair: a prospective randomized study
- Does Footprint Preparation Influence Tendon-to-Bone Healing After Rotator Cuff Repair in an Animal Model?
- Microfracture of greater tuberosity speeds healing of rotator cuff tears
- Suture Anchor Biomechanics After Rotator Cuff Footprint Decortication
- Editorial Commentary: Save the Subchondral Bone in Rotator Cuff Repair Greater Tuberosity Preparation
- Medialization of the supraspinatus tendon:
- indicated for situations in which the rotator cuff cannot be adequately mobilized;
- instead of reattachement of the cuff to greater tuberosity, the cuff is re-attached to a groove created on anatomic neck or on
humeral head;
- as noted by Liu J,et al (1998), about 1 cm of medialization may be acceptable but 17 mm of supraspinatus medialization will
result in a significant reduction in the moment arm;
- ref: Biomechanical Effect of Medial Advancement of the Supraspinatus Tendon. A study in cadavera.
- Mobilization of Rotator Cuff:
- convergence repair
- ref: Modified margin convergence technique using suture anchors for footprint reconstruction of rotator cuff tears.
- Rotator Cuff Repair Techniques:
- direction and positioning of anchors
References:
The influence of medial reattachment of the torn cuff tendon for retracted rotator cuff tears.