rotator cuff repair using knotless self-reinforcing double row system the under surface of the acromion can
be visualized with the arthrosocpe in the sub-acromial space of the right shoulder a radio-frequency ablated is used to clear soft tissue and release
to coracoacromial ligament a limited acromioplasty is performed using an arthroscopic burr next, the superspinatus footprint is debristed and lightly decoricated a massive delaminated tear is identified in this patient. The cuff is then mobilized
and approximated to the repair site the free edge of the tendon is defrosted of
any irregular atrophic tissue a knotless anchor loaded with suture tape is
placed at the posterior aspect of tear one to two millimeters lateral to the articular
margin the anchor is inserted and then advanced flush to bone a suture shuttling device is used
to pass both limbs of the suture tape
approximately one to one point five centimeters mediall to the free edge of the tendon. A second
anterior anchor is placed at the articular margin in
a similar fashion the ap distance between the two anchors should be
a minimum of one to one point five centimeters the sutures are then passed through the anterior aspect
of the tendon insuring that all delamented layers are included in the repair one limb from each anchor is retrieved through
the lateral portal. Soft tissue is then cleared approximately five to ten centimeters lateral to the tuberocity both limbs are loaded through a third knotless anchor which is then placed anteriorly one centimeter lateral to the
tuberocity after the threaded portion of the anchor makes contact with bone the sutures are tensioned and the anchor is advanced flush to bone
the free ends of the suture are then cut this process is repeated with the remaining two utilizing a posterior fixation point as a result an anatomic and water-tight
four strand repair is created this construct is self-reinforcing and
interconnected in nature this video illustrates a second look arthroscopy
four months postoperatively notice how the sutures have become synovialized water-tight healing is demonstrated stable fixation is noted with full
internal and external range of motion this is an illustration of a massive
rotator cuff tear an extended sic anchor contruct
is utilized in this patient restoration of the cuff footprint is obtained