Augmentation of Arthroscopic Rotator Cuff Repair With Cannulated Dermal Allograft Implant

ABSTRACT: Arthroscopic rotator cuff repair (RCR) is a popular treatment for rotator cuff tears. Retear after RCR remains a significant concern even with modern techniques. Augmentation of RCR has been described using multiple different grafts, one option including a cannulated dermal allograft implant (DePuy Mitek). The utilization of this implant avoids significantly increased surgical time, allows for augmentation at the weakest area of repair, and does not lead to any wasted allograft material. Technique Video Video 1 In this video, augmented arthroscopic rotator cuff repair with cannulated dermal allograft is performed on a patient’s right shoulder. Diagnostic arthroscopy is first performed, addressing any associated intra-articular pathology. Preparation for repair is performed in the standard fashion, debriding the footprint of the tear and decorticating the greater tuberosity. A double-row, transosseus equivalent repair construct is used. The medial row anchor is double loaded with a #2 suture and 2.5 mm suture tape. Sutures are passed through the anterior and posterior aspect of the tear. The suture tapes are passed through the central aspect of the tear together using a separate looped suture. The posterior suture and one of the tapes are shuttled into the posterolateral portal for preparation of placement for the posterolateral row anchor. The cannulated dermal allograft is placed onto the suture tape using the applicator and pushed into place near the cannula. The implant is reduced inside the shoulder using a knot pusher. The sutures are loaded on a self-punching anchor and malleted into place. Sutures are sequentially tightened, and when the tear is reduced, the anchor is screwed down to the final position. This process is repeated for the anterolateral row anchor but with the implant being placed on the suture for that anchor. The repair is then inspected, ensuring acceptable reduction and good position of the cannulated dermal allograft implant.

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PROVIDER: S-EPMC9705719 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature