Anchor utilization trends with the implementation of a triple-loaded rotator cuff anchor (original) (raw)
Related papers
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2007
As rotator cuff procedures have moved from open to arthroscopic, more attention has been paid to the use of anchors due to cost concerns and utilization of the real estate of the greater tuberosity footprint. A retrospective case series was performed to analyze anchor utilization during arthroscopic rotator cuff repair after triple-loaded anchors were available in comparison to the use of double-loaded anchors. One consecutive group of 69 patients had RCR with double-loaded anchors and a second consecutive group of 77 patients had RCR after triple-loaded anchors were available. For RC tear size greater than 2.5 cm 2 the use of triple-loaded anchors resulted in a decreased use of nearly 1 anchor per repair. Level of evidence IV.
Arthroscopic Single-Row versus Double-Row Suture Anchor Rotator Cuff Repair
The American Journal of Sports Medicine, 2005
BackgroundRecurrent defects after open and arthroscopic rotator cuff repair are common. Double-row repair techniques may improve initial fixation and quality of rotator cuff repair.PurposeTo evaluate the load to failure, cyclic displacement, and anatomical footprint of 4 arthroscopic rotator cuff repair techniques.HypothesisDouble-row suture anchor repair would have superior structural properties and would create a larger footprint compared to single-row repair.Study DesignControlled laboratory study.MethodsTwenty fresh-frozen cadaveric shoulders were randomly assigned to 4 arthroscopic repair techniques. The repair was performed as either a single-row technique or 1 of 3 double-row techniques: diamond, mattress double anchor, or modified mattress double anchor. Angle of loading, anchor type, bone mineral density, anchor distribution, angle of anchor insertion, arthroscopic technique, and suture type and size were all controlled. Footprint length and width were quantified before and...
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2005
The purpose of this study was to employ a cyclic loading protocol to compare rotator cuff repair strengths of arthroscopically inserted cuff tacks and suture anchors with the traditional open transosseous suture repair. Type of Study: In vitro cadaveric analysis. Methods: Full-thickness 1 ϫ 3-cm rotator cuff defects were created in 25 fresh-frozen cadaveric shoulders, and were randomized to 1 of 4 repair groups: (1) open repair with transosseous sutures, (2) arthroscopic repair with 2 singly loaded suture anchors, (3) arthroscopic repair with 2 doubly loaded suture anchors, and (4) arthroscopic repair with cuff tacks. All repairs were cyclically loaded from 10 to 180 N, and the numbers of cycles to 50% (5-mm gap) and 100% (10-mm gap) failure were recorded. Results: The number of cycles to 100% failure was significantly higher for the arthroscopic doubly loaded suture anchor repairs when compared with the (1) open transosseous suture repair (P ϭ .009), (2) arthroscopic cuff tack repair (P ϭ .003), and (3) arthroscopic singly loaded suture anchor repair (P ϭ .02). Additionally, the number of cycles to 50% failure was significantly higher for all anchors versus open or tack repair (P ϭ .03 for both). Conclusions: Immediate postoperative fixation of rotator cuff repairs with doubly loaded suture anchors was more stable than that provided by the open transosseous suture repairs, arthroscopic singly loaded suture anchors, or cuff tacks. However, additional evaluation is needed to examine the effects on the sustained strength of the repair throughout the healing process. Clinical Relevance: These in vitro results indicate that superior immediate postoperative fixation of rotator cuff repairs may be achieved with the doubly loaded suture anchors. However, additional evaluation is needed to examine the effects on the sustained strength of the repair throughout the healing process.
International Orthopaedics
PURPOSE: The purpose of this study was to evaluate the results of arthroscopic cuff reconstruction, which is currently preferred in our service, and to compare functional outcome after arthroscopic cuff reconstruction comparing different types and sizes of rotator cuff tears. We switched completely from OPEN repair to the full-arthroscopic repair > ten years ago, and since then, we are developing a technique that can produce the best results. Therefore, we decided to verify results. METHODS: Seventy-two patients with rotator cuff tear underwent arthroscopic shoulder surgery. Single-row arthroscopic repair using double- loaded metal anchors and margin-convergence sutures with concomitant procedures were performed in all cases. All patients were assessed and classified before and after surgery using the Constant scoring system and the Oxford Shoulder Score. Tears were measured and classified as medium (1-3 cm), large(3-5 cm) and massive (>5 cm). RESULTS: The average age of parti...
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2007
The goal of rotator cuff repairs is to achieve high initial fixation strength, minimize gap formation, maintain mechanical stability under cyclic loading, and optimize the biology of the tendon-bone interface until the cuff heals biologically to the bone. We have seen an evolution in our approaches to fixing rotator cuff tears from open to mini-open to all arthroscopic. In our arthroscopic techniques, we have also seen a change in the types of anchors and sutures we use and our repair techniques including an evolution in techniques that include single row, double row, and, most recently, transosseous equivalent fixation. Single-row repairs are least successful in restoring the footprint of the rotator cuff and are most susceptible to gap formation. Double-row repairs have an improved load to failure and minimal gap formation. Transosseous equivalent repairs have the highest ultimate load and resistance to shear and rotational forces and the lowest gap formation. This review will discuss the anatomy and biomechanics of a normal rotator cuff, the biomechanical factors that play a role in rotator cuff repairs, the initial fixation repair mechanics, and finally propose an algorithm for rotator cuff fixation based on tissue quality and tear configuration.
Journal of Shoulder and Elbow Surgery, 2008
This prospective study determined whether single-row anchor fixation would reliably improve clinical outcome and maintain structural integrity after arthroscopic repair of single-tendon and 2-tendon rotator cuff tears. In 39 patients, 21 shoulders had single-tendon tears and 18 had 2-tendon tears. Mean follow-up was 38 months (minimum, 24 months). A standardized assessment was done preoperatively and postoperatively at yearly intervals. Postoperative magnetic resonance imaging (MRI) was performed at a minimum 1-year follow-up. Mean forward elevation, pain, satisfaction, and American Shoulder and Elbow Surgeons scores significantly improved for both groups (P < .01). Postoperative MRI examinations showed 19 cuffs (90%) were intact for single-tendon tears and 15 (83%) were intact for 2-tendon tears. A recurrent tear on postoperative MRI was significantly correlated with the intraoperative finding of asymmetric retraction. Arthroscopic rotator cuff repair using single-row anchor fixation resulted in significant improvements in clinical outcome and reliable repair integrity for both singletendon and 2-tendon tears.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2009
The purpose of this study was to compare the clinical outcome of single-row (SR) and double-row (DR) suture anchor fixation in arthroscopic rotator cuff repair with a systematic review of the published literature. Methods: We searched all published literature from January 1966 to December 2008 using Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the Cochrane Central Register of Controlled Trials for the following key words: shoulder, rotator cuff, rotator cuff tear, rotator cuff repair, arthroscopic, arthroscopicassisted, single row, double row, and transosseous equivalent. The inclusion criteria were cohort studies (Levels I to III) that compared SR and DR suture anchor configuration for the arthroscopic treatment of full-thickness rotator cuff tears. The exclusion criteria were studies that lacked a comparison group, and, therefore, case series were excluded from the analysis. Results: There were 5 studies that met the criteria and were included in the final analysis: 5 in the SR group and 5 in the DR group. Data were abstracted from the studies for patient demographics, rotator cuff tear characteristics, surgical procedure, rehabilitation, range of motion, clinical scoring systems, and imaging studies. Conclusions: There are no clinical differences between the SR and DR suture anchor repair techniques for arthroscopic rotator cuff repairs. At present, the data in the published literature do not support the use of DR suture anchor fixation to improve clinical outcome, but there are some studies that report that DR suture anchor fixation may improve tendon healing. Level of Evidence: Level III, systematic review of Levels I to III studies.
JOURNAL OF BIOLOGICAL REGULATORS & HOMEOSTATIC AGENTS, 2020
The aim of our study was to define if Arthroscopic Transosseous Rotator Cuff Techniques should have comparable results to those of the suture-anchors technique in a single row configuration. We reported the preliminary results of a consecutive population of 22 patients who underwent a rotator cuff treatment on the left and right sides for average medium-sized thickness tears with minimal fatty infiltration with the two different techniques: transosseous rotator cuff repair technique on one side and single row with suture-anchors on the other side, in different times. Subjective evaluation with DASH questionnaires, Constant Scores and Numerical Rating Scale (NRS) for pain evaluation, have been submitted pre and postoperatively after both operations. A statistical analysis was performed to assess the superiority of one technique and to compare pre and postoperative ROM data and clinical outcomes. A transosseous rotator cuff repair was performed in 7 patients on the dominant arm, while the other 15 patients had dominant arm cuff tear lesions repaired by using suture-anchors technique. At last follow-up a significant improvement, in shoulder pain and function, was referred at both sides. Also, DASH, Constant Scores and NRS for pain evaluation improved with both techniques, but no statistical difference was found between them. Arthroscopic transosseous rotator cuff repair technique shows comparable results to those of the suture-anchors technique in a single row configuration.