Arthroscopic Repair of Medial Transtendinous Rotator Cuff Tears

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Presentation transcript:

Arthroscopic Repair of Medial Transtendinous Rotator Cuff Tears Brian J. Kelly, M.D., Larry D. Field, M.D. Arthroscopy Techniques Volume 6, Issue 6, Pages e2217-e2221 (December 2017) DOI: 10.1016/j.eats.2017.08.026 Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 1 Arthroscopic view of the right shoulder in the beach chair position from the lateral portal in the subacromial space showing a significant portion of the lateral tendon that remains attached to the greater tuberosity. Arthroscopy Techniques 2017 6, e2217-e2221DOI: (10.1016/j.eats.2017.08.026) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 2 Arthroscopic view of the right shoulder in the beach chair position from the lateral portal in the subacromial space showing the retracted medial portion of the tendon held in an anatomically reduced position. Arthroscopy Techniques 2017 6, e2217-e2221DOI: (10.1016/j.eats.2017.08.026) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 3 Arthroscopic view of the right shoulder in the beach chair position from the posterior portal in the subacromial space showing how the posterior viewing portal facilitates confirmation of the tear pattern and visualization of the greater tuberosity. Arthroscopy Techniques 2017 6, e2217-e2221DOI: (10.1016/j.eats.2017.08.026) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 4 Arthroscopic view of the right shoulder in the beach chair position from the posterior portal in the subacromial space with a tendon grasper attempting to reduce the retracted medial portion of the tendon to the greater tuberosity. It is clear that this would create an overtensioned construct if this portion of the tendon is repaired to the greater tuberosity. Arthroscopy Techniques 2017 6, e2217-e2221DOI: (10.1016/j.eats.2017.08.026) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 5 Arthroscopic view of the right shoulder in the beach chair position from the posterior portal in the subacromial space showing a triple-loaded suture anchor placed at the medial edge of the greater tuberosity after footprint preparation has been completed. Arthroscopy Techniques 2017 6, e2217-e2221DOI: (10.1016/j.eats.2017.08.026) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 6 Arthroscopic view of the right shoulder in the beach chair position from the posterior portal in the subacromial space showing a suture being passed through the lateral portion of the tendon using a retrograde suture retriever. Arthroscopy Techniques 2017 6, e2217-e2221DOI: (10.1016/j.eats.2017.08.026) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 7 Arthroscopic view of the right shoulder in the beach chair position from the lateral portal in the subacromial space showing the medial portion of the tendon held in an anatomically reduced position by a grasper after all suture passage has been completed. Arthroscopy Techniques 2017 6, e2217-e2221DOI: (10.1016/j.eats.2017.08.026) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 8 Arthroscopic view of the right shoulder in the beach chair position from the lateral portal in the subacromial space showing the final repair construct. The tendon has been repaired in an anatomic position without overtensioning the construct. Arthroscopy Techniques 2017 6, e2217-e2221DOI: (10.1016/j.eats.2017.08.026) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions