Knotless anatomic double-layer double-row rotator cuff repair: a novel technique re-establishing footprint and shape of full-thickness tears |
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Authors: | Pierre Hepp Thomas Engel Georg Osterhoff Bastian Marquass Christoph Josten |
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Institution: | (1) Department of Trauma and Reconstructive Surgery, University of Leipzig, Liebigstr. 20, 04103 Leipzig, Germany |
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Abstract: | The standard technique for restoring footprint after full-thickness tears of the rotator cuff includes double-row or transosseous-equivalent
techniques. However, the anatomically typical bird’s beak shape and profile of tendon insertion may not be originally restored
and biomechanics may be altered. In this report, the authors describe a technique that involves creating two intratendinous
stitches at different levels of the torn tendon. The first passes through the bursal-side layer, the second stitch through
the joint-side layer. Both stitches may be performed in mattress suture configuration. The anchorage is performed by knotless
anchors in order to avoid knots lying within the insertion area. The footprint is restored first medially then laterally by
the use of double-row principles. The joint-side suture is anchored within the medially placed anchor. The bursal-side suture
is anchored by a laterally placed anchor. The anatomic insertion and restoration of the shape and profile may be enabled by
the described double-layer suture technique. Using a double-layer double-row repair may potentially improve functional results
of rotator cuff repair constructs. |
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Keywords: | Full-thickness tear Rotator cuff Arthroscopic repair Footprint Double-layer double row Knotless anchor |
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