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Double Row Knotted "Trident": 1 Suture Technique for Superior to Posterosuperior Small Cuff Tear.

ABSTRACT: Many arthroscopy suture techniques have been described for small rotator cuff tears, but there is no consensus. The aim of this study is to describe a double-row knot technique, which we call a "trident point," for the superior and posterosuperior small cuff tear that is easily reproducible and has a fast learning curve. This knot takes into account the excess of tendon tissue on the foot print after a cuff suture, called a "dog-ear deformity." However clinical, ultrasound, and biomechanical evaluation with follow-up remains necessary to validate the sustainability of this arthroscopy technique.

SUBMITTER: Commeil P

PROVIDER: S-EPMC7953229 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Modified Double-Row Suture Bridge Technique With Double-Row Biceps Tenodesis for Massive Rotator Cuff Tear.

Project description:This article aims to describe a modification of the arthroscopic suture bridge technique for repair of a massive (>3 cm) rotator cuff tear. The method uses 2 medial anchors and 2 lateral anchors for rotator cuff repair, as well as double-row biceps tenodesis. This operative modification may impart better tendon healing and fewer rupture complications than the traditional double-row repair techniques.

| S-EPMC7301334 | biostudies-literature

A Technique for a Suture-Based Cable Reconstruction of an Irreparable Posterosuperior Rotator Cuff Tear.

Project description:The management of irreparable rotator cuff tears remains challenging. In patients in whom a complete repair cannot be obtained, a partial repair remains an option. The goal of a partial rotator cuff repair is to obtain a stable glenohumeral joint fulcrum by restoring the rotator cable complex. Traditionally, partial repair has been performed with independent reattachment(s) of the rotator cable complex with or without margin convergence medially. This Technical Note describes an alternative approach to a partial rotator cuff repair with a suture-based cable reconstruction.

| S-EPMC9705767 | biostudies-literature

Arthroscopic Rotator Cuff Repair: Double-Row Transosseous Equivalent Suture Bridge Technique.

Project description:Following a failed course of conservative management, arthroscopic rotator cuff repair (ARCR) has become the gold standard treatment for patients presenting with symptomatic rotator cuff (RC) tears. Traditionally, the single-row repair technique was used. Although most patients enjoy good to excellent clinical outcomes, structural healing to bone remains problematic. As a result, orthopaedic surgeons have sought to improve outcomes with various technological and technical advancements. One such possible advancement is the double-row technique. We present a method for repairing an RC tear using double-row suture anchors in a transosseous equivalent suture bridge technique. The double-row technique is believed to more effectively re-create the anatomic footprint of the tendon, as well as increase tendon to bone surface area, and apposition for healing. However, it requires longer operating times and is costlier. This report highlights this technique for ARCR in an adult by using a double-row transosseous equivalent suture bridge.

| S-EPMC5263183 | biostudies-literature

How to Maximize Suture Tension in Double-Row Suture-Bridge Rotator Cuff Repair?

Project description:Double-row suture-bridge technique for rotator cuff repair has been used for rotator cuff tears. In large tears that require 2 or more lateral row anchors, loosening of the suture bridges could occur because of tightening sequence. By retightening suture limbs before deploying the first lateral row anchor, premature loosening could be prevented and enhance the tension of the construct.

| S-EPMC8556532 | biostudies-literature

Knotted Versus Knotless Medial-Row Transosseous-Equivalent Double-Row Rotator Cuff Repairs Have Similar Clinical and Functional Outcomes.

Project description:PurposeTo retrospectively investigate the clinical and functional outcomes of patients who underwent knotted medial-row rotator cuff repair (KT-RCR) compared with patients who underwent knotless medial-row rotator cuff repair (KL-RCR).MethodsA retrospective chart review of patients who underwent double-row transosseous-equivalent rotator cuff repair in 2016 was performed at a single institution with 2-year follow-up. Information regarding demographic characteristics, preoperative tear size (magnetic resonance imaging), surgical variables (including method of suture stabilization), preoperative and postoperative American Shoulder and Elbow Surgeons (ASES) scores, and all complications (e.g., cuff failure, adhesive capsulitis, and persistent pain) was compiled.ResultsA total of 189 patients met the inclusion criteria: 72 in the KL-RCR group and 117 in the KT-RCR group. No significant difference in preoperative ASES scores was found between the KL-RCR and KT-RCR groups (48.3 vs 45.4, P = .327). Postoperative ASES scores did not differ between the groups (82.4 for KL-RCR vs 78.8 for KT-RCR, P = .579). We found no significant difference in cuff failure rates after 2 years, determined by magnetic resonance imaging (5.6% for KL-RCR vs 6.1% for KT-RCR, P > .999), or complication rates (11.1% for KL-RCR vs 8.6% for KT-RCR, P = .743).ConclusionsThe knotted approach and knotless approach to double-row rotator cuff repair showed similar outcome scores, cuff failure rates, and complication rates at minimum 2-year follow-up.Level of evidenceLevel III, retrospective therapeutic comparative trial.

| S-EPMC9042748 | biostudies-literature

Triple-Row Modification of the Suture-Bridge Technique for Arthroscopic Rotator Cuff Repair.

Project description:Recent advances to improve outcomes in rotator cuff repair include using arthroscopic double-row suture-bridge techniques in an effort to reconstruct the rotator cuff footprint and improve fixation. However, when using this technique for larger tears, it can be difficult to get the lateral portion of the rotator cuff into an anatomic position. This report describes a triple-row modification of the suture-bridge technique that results in significantly more footprint contact area and contact pressure compared with the double-row and standard suture-bridge techniques. Maximizing the rotator cuff footprint contact area exposes more of the tendon to bone and may improve the healing potential.

| S-EPMC5124061 | biostudies-literature

Tear characteristics and surgeon influence repair technique and suture anchor use in repair of superior-posterior rotator cuff tendon tears.

Project description:BACKGROUND:The factors that associate with surgical decisions about repair technique and the number of suture anchors used in rotator cuff repair have not been previously investigated. This study investigated the extent to which patient, surgeon, and surgical factors associate with performing single-row vs. double-row repair technique and ultimately with the number of suture anchors used. METHODS:Our institution's prospective surgical cohort was queried for patients undergoing suture anchor repair of superior-posterior rotator cuff tendon tears between February 2015 and August 2017. Exclusion criteria were patients with isolated subscapularis tears, tears that were not repaired, repairs without suture anchors, repairs involving graft augmentation, and repairs by surgeons with fewer than 10 cases. Multivariable statistical modeling was used to investigate associations between patient and surgical factors and the choice of repair technique and number of suture anchors used. RESULTS:A total of 925 cases performed by 13 surgeons met inclusion criteria. Tear type (full thickness), tear size (medium, large, and massive), a greater number of torn tendons, repair type (arthroscopic), and surgeon were significantly associated with performing a double-row over a single-row repair. Tear size, a greater number of torn tendons, double-row repair technique, and surgeon were significantly associated with a greater number of anchors used for repair. CONCLUSIONS:Our findings suggest that in the absence of data to conclusively support a clinical benefit of one repair technique over another, surgeons' training, experience, and inherent practice patterns become the primary factors that define their surgical methods.

| S-EPMC6339588 | biostudies-literature

Endoscopic Repair of Proximal Hamstring Tear With Double-Row Suture Bridge Construct.

Project description:Hamstring strains account for 25% to 30% of all muscle strains and are an exceedingly common injury in the athletic population. Although proximal hamstring avulsion injuries occur less commonly than strains at the myotendinous junction, they are more severe and debilitating. Proximal hamstring avulsions do not respond well to conservative treatment and are more likely to require surgical intervention. Surgical repair of proximal hamstring avulsions is indicated when the injury fails to respond to conservative treatment, in cases of osseous avulsion with retraction, and in cases of tearing of all 3 hamstring tendons. Endoscopic repair of proximal hamstring avulsions is a promising technique to repair these injuries while reducing morbidity. We describe our technique for endoscopic proximal hamstring repair, which uses a double-row suture bridge construct to reattach the tendons to the ischial tuberosity.

| S-EPMC6713840 | biostudies-other

Tension band wiring versus suture anchor technique in patellar inferior pole fracture: Novel double row suture anchor technique.

Project description:IntroductionPatellar inferior pole fractures are challenging to obtain sufficient fixation. The purpose of this retrospective, case-controlled study was to compare the clinical and radiological outcomes between tension band wiring (TBW) and our novel double-row suture anchor (SA) technique in patellar inferior pole fractures.Materials and methodsThis retrospective study included patients who underwent TBW or SA fixation for patellar inferior pole fractures from 2015 to 2019. A total of 63 patients were divided into two groups according to the surgical procedure: the TBW group (n = 35) and the SA fixation group (n = 28). The visual analog scale score, range of motion of the knee, Lysholm score, Kujala patellofemoral score, and patient satisfaction score were evaluated for clinical and functional outcomes. Radiological outcomes included the time to radiological union, loss of reduction, and the Insall-Salvati (IS) ratio.ResultsSignificant improvements in clinical outcomes were observed in both groups with no significant differences. Bone union was achieved in all patients, and there was no significant difference in the time to radiological union and the IS ratio between the two groups. All patients in the TBW group underwent additional surgeries for implant removal. However, none of the patients in the SA group underwent implant removal or experienced skin irritation.ConclusionOur novel double-row SA technique could provide comparable fixation strength and good clinical outcomes, with fewer complications in patellar inferior pole fractures. This novel SA technique is a satisfactory alternative treatment for patellar inferior pole fractures.

| S-EPMC9758291 | biostudies-literature

"Double-Row Rip-Stop" Technique for Arthroscopic Rotator Cuff Repair.

Project description:Rotator cuff repair depends on both the fixation strength of the chosen repair construct and the local healing response of the repaired tissue. Among a growing discussion surrounding the superiority of one surgical technique over another, the surgeon's ability to complete a rotator cuff repair with technical acuity in a timely manner remains paramount. Double-row repairs as well as rip-stop configurations have been proposed to limit failures found after arthroscopic rotator cuff repairs. Implementation of both techniques during arthroscopic shoulder surgery may represent a technical challenge for the average orthopaedist. The purpose of this article is to give simple instructions for reproduction of an arthroscopic double-row rip-stop repair for rotator cuff fixation.

| S-EPMC5799086 | biostudies-other

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