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Arthroscopic Low-Profile Knotless Repair of SLAP Tears With Suture Tape.

ABSTRACT: SLAP tears have been a controversial topic in shoulder surgery for decades. The indications for repair of SLAP tears, as well as the methods of repair, have undergone a recent evolution. The use of intra-articular knots for SLAP repair has fallen out of favor because of potential abrasive damage to the rotator cuff and glenohumeral articular cartilage due to knot migration and prominence. In response to this potential iatrogenic injury, arthroscopic techniques have undergone an evolution using advanced techniques with low-profile knotless repairs. We describe our preferred low-profile knotless technique for SLAP repair using LabralTape (Arthrex) in a horizontal mattress configuration.

SUBMITTER: Mostello AJ

PROVIDER: S-EPMC7587043 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Arthroscopic Low-Profile Knotless Repair of SLAP Tears With Suture Tape.

Mostello Andrew J AJ Caldwell Paul E PE Pearson Sara E SE

Arthroscopy techniques 20200918 10

SLAP tears have been a controversial topic in shoulder surgery for decades. The indications for repair of SLAP tears, as well as the methods of repair, have undergone a recent evolution. The use of intra-articular knots for SLAP repair has fallen out of favor because of potential abrasive damage to the rotator cuff and glenohumeral articular cartilage due to knot migration and prominence. In response to this potential iatrogenic injury, arthroscopic techniques have undergone an evolution using a ...[more]

PMID: 33134052

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Project description:With an increased appreciation of the importance an intact meniscus has on normal knee kinematics and function, more meniscal tears are being treated with a repair rather than partial meniscectomy. There are several techniques for repairing torn meniscal tissue, including the outside-in, inside-out, and all-inside repairs. Each technique comes with its advantages and drawbacks. The inside-out and outside-in techniques allow for greater control of the repair using knots outside the joint capsule; however, they pose a risk for neurovascular injury and require additional incisions. Arthroscopic all-inside repairs have seen increasing popularity, but with current techniques, fixation is achieved either with intra-articular knots or extra-articular implants, leading to variable outcomes and the potential for postoperative complications. This technical note describes the use of SuperBall, an all-inside meniscus repair device that provides an all-arthroscopic approach, no intraarticular knots or implants, and surgeon-guided tensioning of the meniscus repair. Technique Video Video 1 Tear of the right lateral meniscus posterior horn repaired with the SuperBall repair device. Right leg is placed in figure-four position, and tear is visualized with an arthroscope via the lateral portal. The Superball depth limiter is adjusted to 16 mm and inserted into medial portal. Red safety button depressed and delivery needle are lowered to desired depth. The first suture bundle is deployed at desired location using the system trigger. Needle is repositioned to the second location for suture bundle, and trigger is pressed until hard stop is felt. Device is then repeatedly triggered until sufficient tension is achieved, and meniscal tear is reduced. Red suture cutting button is depressed, and the blue Superball pusher is retracted to rear position and pushed back down to initial position to deploy Superball suture tail on the peripheral side of the meniscus. The green actuating suture is gently pulled to secure repair, the device is removed, and the suture is cut flush with meniscus. The 2nd SuperBall device is used a few millimeters posterior to the first.

Dataset Information

Arthroscopic Low-Profile Knotless Repair of SLAP Tears With Suture Tape.

Publications

Arthroscopic Low-Profile Knotless Repair of SLAP Tears With Suture Tape.

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