Blended Suture-bridge Technique for Arthroscopic Rotator Cuff Repair
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PROVIDER: S-EPMC10150159 | biostudies-literature | 2023 Mar
REPOSITORIES: biostudies-literature
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Project description:Following a failed course of conservative management, arthroscopic rotator cuff repair (ARCR) has become the gold standard treatment for patients presenting with symptomatic rotator cuff (RC) tears. Traditionally, the single-row repair technique was used. Although most patients enjoy good to excellent clinical outcomes, structural healing to bone remains problematic. As a result, orthopaedic surgeons have sought to improve outcomes with various technological and technical advancements. One such possible advancement is the double-row technique. We present a method for repairing an RC tear using double-row suture anchors in a transosseous equivalent suture bridge technique. The double-row technique is believed to more effectively re-create the anatomic footprint of the tendon, as well as increase tendon to bone surface area, and apposition for healing. However, it requires longer operating times and is costlier. This report highlights this technique for ARCR in an adult by using a double-row transosseous equivalent suture bridge.
| S-EPMC5263183 | biostudies-literature
Project description:Recent advances to improve outcomes in rotator cuff repair include using arthroscopic double-row suture-bridge techniques in an effort to reconstruct the rotator cuff footprint and improve fixation. However, when using this technique for larger tears, it can be difficult to get the lateral portion of the rotator cuff into an anatomic position. This report describes a triple-row modification of the suture-bridge technique that results in significantly more footprint contact area and contact pressure compared with the double-row and standard suture-bridge techniques. Maximizing the rotator cuff footprint contact area exposes more of the tendon to bone and may improve the healing potential.
| S-EPMC5124061 | biostudies-literature
Project description:Numerous techniques have been formulated for increasing the tendon-bone contact area and for providing a better healing environment for the tendon in cases of rotator cuff tear. An ideal rotator cuff repair maximizes the tendon-bone interface and provides the rotator cuff with sufficient biomechanical strength for it to withstand a high load. In this article, we propose a technique with the advantages of both the double-pulley and the rip-stop suture-bridge techniques, which increases the pressurized contact area along the medial row, achieves higher failure loads than non-rip-stop techniques, and reduces tendon cut-through.
| S-EPMC9984839 | biostudies-literature
Project description:The double-row suture technique and the suture-bridge technique have been used for rotator cuff repair to decrease the occurrence of retears. However, when only the degenerated tendon end is sutured, the risk of retear remains. The augmentation suture technique is a new procedure that connects the intact medial tendon to the lateral greater tuberosity, and this approach may protect the initial repair site. The procedures for this technique are as follows: 2 sutures are placed through the medial intact tendon, the cuff tear is repaired by the single-row technique, 2 sutures are pulled laterally over the single-row repair site, and 2 sutures are fixed at the lateral greater tuberosity with a push-in-type anchor. This technique is simple and easy and does not require special equipment. Moreover, this approach can augment the single-row repair technique without creating high tension at the cuff end.
| S-EPMC4129987 | biostudies-literature
Project description:Tendinopathy of the long head of the biceps is often found as an intra-articular pathology in the glenohumeral joint. Because long head of the biceps lesions are common, surgical intervention to properly manage the long head of the biceps has become an important issue. Both tenodesis and tenotomy have been shown to provide benefits in biceps long head tendinopathy. But because of concerns about muscle power reduction, cramping, and "Popeye's deformity," which may result from biceps tenotomy, biceps tenodesis is a good option for treating biceps lesions. Here, we describe a time-saving, simple, and secure biceps tenodesis method during rotator cuff repairs, which is a combination of an adjacent soft-tissue tenodesis and a bony suprapectoral tenodesis, by performing a combined tenodesis (soft + bony), and we believe that the shoulder joint will gain more strength and loosening complications will be reduced.
| S-EPMC5124374 | biostudies-literature
Project description:Arthroscopic rotator cuff repair is mainly based on 2 proven biomechanical concepts: suture bridge and tension band. This Technical Note describes the use of a combination of these 2 techniques to repair extensive lesions with only 3 anchors. Besides being less expensive, the use of a limited number of anchors is part of a global medicoeconomic and eco-responsible approach to our surgical activities.
| S-EPMC9827004 | biostudies-literature
Project description:At present, suture bridge is a feasible choice in the treatment of massive rotator cuff tears (MRCTs). However, high tension on the repair site and medial tension during suture tightening and after medial knotting are unavoidable problems in MRCT repair with a suture bridge. Arthroscopic V-shaped double-pulley suture-bridge repair is a pragmatic surgical technique for the repair of MRCTs. The unique parallel design of medial- and lateral-row anchors can minimize tendon tension on the apex portion; 6 sets of double-pulley suture bridges can not only provide sufficient tendon-bone contact area but also reduce the tendon retear rate. Moreover, medial knotless techniques can reduce tendon tension.
| S-EPMC11662884 | biostudies-literature
Project description:Rotator cuff (RC) tears represent one of the most common causes of pain and dysfunction of the shoulder. Numerous RC repair techniques have been reported. In this Technical Note, we introduce an arthroscopic double-row repair technique that combines a suture bridge construct with modified Mason-Allen and simple suture fixation to optimize load-sharing and compression of the RC to the footprint. The described technique is ideal for crescent-shaped and large reparable U-shaped posterosuperior RC tears.
| S-EPMC9827121 | biostudies-literature
Project description:PurposeTo compare the clinical and imaging outcome of arthroscopic transosseous (TO)-equivalent rotator cuff repair (RCR) with anchors with arthroscopic anchorless TO RCR at a minimum of 2 years postoperatively.MethodsThe study population included patients who underwent RCR using either an anchorless TO technique with a TO suture passing device (group A) and those who were matched for tear size and underwent RCR using suture anchors for repair (group B). The inclusion criterion was an easily reducible rotator cuff tear with a sagittal extension of 2 to 4 cm. After a minimum of 2 years, clinical outcome scores and magnetic resonance imaging were obtained. Tendon quality and footprint integration were evaluated using the Sugaya classification.ResultsSeventy patients were included. A total of 45 were in group A and 25 were in group B. Group A had 2 bone tunnels and 4 sutures using an X-box configuration, and group B had a suture bridge construct of 4 anchors. Group A and B had identical anteroposterior tear size and were comparable for age. The Constant score improved from 50 ± 17.4 to 88 ± 8.6 in group A versus 48 ± 14.5 to 87 ± 7.2 in B. The Subjective Shoulder Value rose from 47 ± 19.1 to 95 ± 7.4 in group A vs from 47 ± 19.4 to 95 ± 7.6 in B. Neither the preoperative (P ≥ .502) nor postoperative scores (P ≥ .29) showed a significant difference. Magnetic resonance imaging showed 2 small retears in group A and one in B, resulting in an identical 4% retear rate. The mean Sugaya type was 2.02 versus 2.24 (P = .206) for groups A versus B.ConclusionsAnchorless TO RCR is a valid alternative to suture anchor techniques. Clinical outcome data showed comparable results for both techniques after a follow-up of 2 years. The healing results as observed on magnetic resonance imaging were also equivalent for both groups.Level of evidenceLevel III, retrospective comparative study.
| S-EPMC9791879 | biostudies-literature
Project description:Advancements in rotator cuff tear repair have led to innovative techniques for complex cases. In this article, we introduce the "shoe shop" lacing technique, a knotless, side-to-side, and tendon-to-bone suture method augmented with the long head of the biceps tendon (LHBT) for anterior margin-deficient massive rotator cuff tears. This approach offers simplicity, durability, and potential advantages in biomechanics. The LHBT integration and knotless sutures make it a promising solution for challenging tear patterns. This technique provides an attractive option for arthroscopic repair, improving outcomes in cases where anterior cable reinforcement is essential.
| S-EPMC11258873 | biostudies-literature