- Considerations for Arthroscopic Repair:
- required steps: there are several steps for arthroscopic cuff repair and each step needs to be optimally performed w/o interfering w/ other steps;
- passage of sutures for optimal tendon grasp
- bone anchor insertion
- tensioning of sutures (rather than using knots)
- locking of sutures to anchor (rather than locking of the sutures against bone)
- Suture Bone Tunnel Repair: (Open Repair)
- Bone Anchor Technique:
- modified convergence technique:
- bone anchors are inserted at anterior aspect of supraspinatus foot print;
- direction of insertion:
- insertion of anchors at a 45 deg angle to the bone surface is recommended;
- Early pullout of lateral row knotless anchor in rotator cuff repair
- Proper insertion angle is essential to prevent intra-articular protrusion of a knotless suture anchor in shoulder rotator cuff repair
- Tendon Suture Passage Considerations:
- core sutures for hand flexor tendon lacerations
- Charlotte Shoulder System
- Rip Stop Repair Techniques:
- A load-sharing rip-stop fixation construct for arthroscopic rotator cuff repair.
- Bone Anchor Options:
- suture knots need to be kept lateral to the greater tuberosity so as to avoid impingement under the acromion;
- SpeedScrew (lateral row)
- JuggerKnot (medial row)
- Mitek Healix Anchor
- HEALIX TM BR Anchor with ORTHOCORD Suture Anchor In-Vitro Performance
- HEALIX TM BR & HEALIXTM PEEK Anchor with ORTHOCORD Suture Abrasion White Paper
A biomechanical evaluation of suture anchors in repair of the rotator cuff.
The strength of surgical repairs of the rotator cuff. A biomechanical study on cadavers.
The mechanical effects of suture anchor insertion angle for rotator cuff repair.
Cyclic loading of anchor-based rotator cuff repairs: confirmation of the tension overload phenomenon and comparison of suture anchor fixation with transosseous fixation.
Biomechanical Evaluation of Arthroscopic Rotator Cuff Repairs: Double-Row Compared with Single-Row Fixation.
Arthroscopic Double-Row and “Transosseous-Equivalent” Rotator Cuff Repair
Humeral Insertion of the Supraspinatus and Infraspinatus. New Anatomical Findings Regarding the Footprint of the Rotator Cuff
Vascularity of the supraspinatus tendon three months after repair: Characterization using contrast-enhanced ultrasound.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Clifford R. Wheeless, III, MD on Thursday, April 9, 2015 6:52 am