Clinical and Economic Advantages of Anchorless Arthroscopic Transosseous Suture Repair of the Rotator Cuff
Main Article Content
Abstract
In 2005, an anchorless technique was developed for arthroscopic transosseous rotator cuff repair to reproduce open surgery. Since May 2015, the retear rate has decreased with the use of absorbable sutures in mattress suturing. This study analyzed 389 patients who underwent surgery using absorbable mattress sutures. Three 2-mm Kirschner wires with perforated tips were inserted through the inferior margin of the greater tuberosity into the medial edge of the footprint. After pulling the rotator cuff stump laterally, three Kirschner wires were penetrated through the rotator cuff and skin. Two glycolic acid and three polyester sutures were passed through three bone tunnels using the perforated tips of the Kirschner wires. Surgery was completed by inserting two absorbable mattress sutures and three nonabsorbable bridging sutures. The retear rate after surgery with absorbable mattress sutures was 1.8%. The cost of surgical materials used in our procedure was $12. The application of an absorbable suture in mattress suturing was associated with a low retear rate. Further, this technique only requires sutures. Hence, it is considered economically advantageous.
Keywords:
Shoulder joint, Rotator cuff, Arthroscopy, Transosseous suture, Suture technique, Absorbable suture, Anchorless
Article Details
How to Cite
KURODA, Shigehito.
Clinical and Economic Advantages of Anchorless Arthroscopic Transosseous Suture Repair of the Rotator Cuff.
Medical Research Archives, [S.l.], v. 9, n. 5, may 2021.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2406>. Date accessed: 26 dec. 2024.
doi: https://doi.org/10.18103/mra.v9i5.2406.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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3. Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double-row cuff repair: a prospective outcome study. J Bone Joint Surg Am. 2007; 89(5):953-960. [PMID: 17473131]; [DOI: 10.2106/JBJS.F.00512]
4. Ellman H, Hanker G, Bayer M. Repair of the rotator cuff: endresult study of factors influencing reconstruction. J Bone Joint Surg Am. 1986; 68(8):1136-1144. [PMID: 3771595]
5. Codman EA. Complete rupture of the supraspinatus tendon. Operative treatment with report of two successful cases. Boston Med Surg J. 1911; 164: 708-710. [PMID: 21288744]; [DOI: 10.1016/j.jse.2010.10.031]
6. Fleega BA. The giant needle rotator cuff repair system, technique and results. J Bone Joint Surg Br. 1997; 79(Suppl II): 196.
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11. Liu XN, Yang CJ, Lee GW, Kim SH, Yoon YH, Noh KC. Functional and Radiographic Outcomes After Arthroscopic Transosseous Suture Repair of Medium Sized Rotator Cuff Tears. Arthroscopy. 2018; 34(1): 50-57. [PMID: 29079262]; [DOI: 10.1016/j.arthro.2017.07.035]
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16. Hubert F, Manuel H, Martin V, Jens S. Arthroscopic Bone Needle: A New, Safe, and Cost-effective Technique for Rotator Cuff Repair. Techniques in Shoulder & Elbow Surgery. 2010; 11(4): 107-112. [DOI: 10.1097/BTE.0b013e3181fdb375]
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18. Chillemi C, Mantovani M, Osimani M, Castagna A. Arthroscopic transosseous rotator cuff repair: the eight-shape technique. Eur J Orthop Surg Traumatol. 2017; 27(3): 399-404. [PMID: 28124131]; [DOI: 10.1007/s00590-017-1906-z]
19. Sanders B. True Transosseous Hybrid Rotator Cuff Repair. Arthrosc Tech. 2019; 5; 8(9): e1013-e1018. [PMID: 31687334]; [PMCID: PMC6819739]; [DOI: 10.1016/j.eats.2019.05.012]
20. Atoun A, Kane LT and Abboud JA. Arthroscopic, Needle-Based, Transosseous Rotator Cuff Repair. Arthrosc Tech. 2019; 18;9(1): e57-e63. [DOI: 10.1016/j.eats.2019.09.004]
21. Gutiérrez MA, Menduiña AM, Mora MV, and Boyle S. All Suture Transosseous Repair for Rotator Cuff Tear Fixation Using Medial Calcar Fixation. Arthroscopy Techniques. 2015; 4(2): e169-e173. [PMID: 26052495]; [PMCID: PMC4454820]; [DOI: 10.1016/j.eats.2015.01.001]
22. Duquin TR, Buyea C, Bisson LJ. Which method of rotator cuff repair leads to the highest rate of structural healing? A systematic review. Am J Sports Med. 2010; 38(4): 835-841. [PMID: 20357403]; [DOI: 10.1177/0363546509359679]
23. Benson EC, MacDermid JC, Drosdowech DS, Athwal GS. The incidence of early metallic suture anchor pullout after arthroscopic rotator cuff repair. Arthroscopy. 2010; 26(3):310–315. [DOI 10.1016/j.arthro.2009.08.015]
24. Blas-Dobón JA, Aguilella L, Montaner-Alonso D and Morales-Suárez-Varela M. Arthroscopic transosseous rotator cuff repair: how to avoid damaging the axillary nerve—a cadaveric study. Archives of Orthopaedic and Trauma Surgery. 2020; 140(11): 1767–1774 [DOI: 10.1007/s00402-020-03528-x]
25. Gupta H, Mishra P, Kataria H, Jain V, Tyagi AR, Mahajan H, Upadhyay AD. Optimal angle of the bone tunnel for avoiding axillary nerve injuries during arthroscopic transosseous rotator cuff repair: a magnetic resonance imaging-based simulation study. Orthop J Sports Med. 2018; 9; 6(11):2325967118806295. [PMC6240968];
[DOI: 10.1177/2325967118806295]
26. Kuroda S, Ishige N, Mikasa M. Reply to the Letter to the Editor. Advantages of Arthroscopic Transosseous Suture Repair of the Rotator Cuff without the Use of Anchors. Clin Orthop Relat Res. 2014; 472(3): 1044-1045. [PMID: 24363188]; [PMCID: PMC3916621]; [DOI: 10.1007/s11999-013-3435-3]
2. Kuroda S, Ishige N, Ogino S, Ishii T. Arthroscopic Transosseous Suture Without Implant for Rotator Cuff Tears: Absorbable Mattress Sutures Versus NonAbsorbable Sutures. Int. J. of Orth. 2019; 28; 6(1): 1003-1011. [DOI: 10.17554/j.issn.2311-5106.2019.06.281-3]
3. Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double-row cuff repair: a prospective outcome study. J Bone Joint Surg Am. 2007; 89(5):953-960. [PMID: 17473131]; [DOI: 10.2106/JBJS.F.00512]
4. Ellman H, Hanker G, Bayer M. Repair of the rotator cuff: endresult study of factors influencing reconstruction. J Bone Joint Surg Am. 1986; 68(8):1136-1144. [PMID: 3771595]
5. Codman EA. Complete rupture of the supraspinatus tendon. Operative treatment with report of two successful cases. Boston Med Surg J. 1911; 164: 708-710. [PMID: 21288744]; [DOI: 10.1016/j.jse.2010.10.031]
6. Fleega BA. The giant needle rotator cuff repair system, technique and results. J Bone Joint Surg Br. 1997; 79(Suppl II): 196.
7. Fleega BA. Arthroscopic transhumeral rotator cuff repair: Giant needle technique. Arthroscopy. 2002; 18(2): 218-223. [DOI: 10.1053/jars.2002.30661]
8. Garrigues GE, Lazarus MD. Arthroscopic bone tunnel augmentation for rotator cuff repair. Orthopedics. 2012; 35(5): 392-397. [PMID: 22588393]; [DOI: 10.3928/0147744720120426-04]
9. Garofalo R, Castagna A, Borroni M, Krishnan SG. Arthroscopic transosseous (anchorless) rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 2012; 20(6): 1031-1035. [PMID: 22011882]; [DOI: 10.1007/s00167-011-1725-4]
10. Randelli P, Stoppani CA, Zaolino C, Menon A, Randelli F, Cabitza P. Advantages of Arthroscopic Rotator Cuff Repair With a Transosseous Suture Technique: A Prospective Randomized Controlled Trial. Am J Sports Med. 2017; 45(9): 2000-2009. [PMID: 28339286]; [DOI: 10.1177/0363546517695789]
11. Liu XN, Yang CJ, Lee GW, Kim SH, Yoon YH, Noh KC. Functional and Radiographic Outcomes After Arthroscopic Transosseous Suture Repair of Medium Sized Rotator Cuff Tears. Arthroscopy. 2018; 34(1): 50-57. [PMID: 29079262]; [DOI: 10.1016/j.arthro.2017.07.035]
12. Black, EM, Lin, A, Srikumaran, U, Jain, N, Freehill, MT. Arthroscopic transosseous rotator cuff repair: technical note, outcomes, and complications. Orthopedics. 2015; 38(5): e352-e358. [PMID: 25970360]; [PMCID: PMC4712630]; [DOI: 10.3928/01477447-20150504-50]
13. Flanagin BA, Garofalo R, Lo EY, Feher L, Castagna A, Qin H, Krishnan SG. Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair. Int J Shoulder Surg. 2016; 12(1): 3-9. [PMID: 26980983]; [PMCID: PMC4772414]; [DOI: 10.4103/0973-6042.174511]
14. Matis N, Hübner C, Aschauer E, Resch H. Arthroscopic Transosseous Reinsertion of the Rotator Cuff. Operat Orthop Traumatol. 2006; 18(1): 1-18. [PMID: 16534558]; [DOI: 10.1007/ s00064-006-1159-1]
15. Tauber M, Koller H, Resch H. Transosseous arthroscopic repair of partial articular-surface supraspinatus tendon tears. Knee Surg Sports Traumatol Arthrosc. 2008; 16(6): 608-613. [PMID: 18418574]; [DOI: 10.1007/s00167-008-0532-z]
16. Hubert F, Manuel H, Martin V, Jens S. Arthroscopic Bone Needle: A New, Safe, and Cost-effective Technique for Rotator Cuff Repair. Techniques in Shoulder & Elbow Surgery. 2010; 11(4): 107-112. [DOI: 10.1097/BTE.0b013e3181fdb375]
17. Chillemi C and Mantovani M. Arthroscopic trans-osseous rotator cuff repair. Muscles Ligaments Tendons J. 2017; 7(1): 19-25. [PMID: 28717607]; [PMCID: PMC5505589]; [DOI: 10.11138/ mltj/2017.7.1.019]
18. Chillemi C, Mantovani M, Osimani M, Castagna A. Arthroscopic transosseous rotator cuff repair: the eight-shape technique. Eur J Orthop Surg Traumatol. 2017; 27(3): 399-404. [PMID: 28124131]; [DOI: 10.1007/s00590-017-1906-z]
19. Sanders B. True Transosseous Hybrid Rotator Cuff Repair. Arthrosc Tech. 2019; 5; 8(9): e1013-e1018. [PMID: 31687334]; [PMCID: PMC6819739]; [DOI: 10.1016/j.eats.2019.05.012]
20. Atoun A, Kane LT and Abboud JA. Arthroscopic, Needle-Based, Transosseous Rotator Cuff Repair. Arthrosc Tech. 2019; 18;9(1): e57-e63. [DOI: 10.1016/j.eats.2019.09.004]
21. Gutiérrez MA, Menduiña AM, Mora MV, and Boyle S. All Suture Transosseous Repair for Rotator Cuff Tear Fixation Using Medial Calcar Fixation. Arthroscopy Techniques. 2015; 4(2): e169-e173. [PMID: 26052495]; [PMCID: PMC4454820]; [DOI: 10.1016/j.eats.2015.01.001]
22. Duquin TR, Buyea C, Bisson LJ. Which method of rotator cuff repair leads to the highest rate of structural healing? A systematic review. Am J Sports Med. 2010; 38(4): 835-841. [PMID: 20357403]; [DOI: 10.1177/0363546509359679]
23. Benson EC, MacDermid JC, Drosdowech DS, Athwal GS. The incidence of early metallic suture anchor pullout after arthroscopic rotator cuff repair. Arthroscopy. 2010; 26(3):310–315. [DOI 10.1016/j.arthro.2009.08.015]
24. Blas-Dobón JA, Aguilella L, Montaner-Alonso D and Morales-Suárez-Varela M. Arthroscopic transosseous rotator cuff repair: how to avoid damaging the axillary nerve—a cadaveric study. Archives of Orthopaedic and Trauma Surgery. 2020; 140(11): 1767–1774 [DOI: 10.1007/s00402-020-03528-x]
25. Gupta H, Mishra P, Kataria H, Jain V, Tyagi AR, Mahajan H, Upadhyay AD. Optimal angle of the bone tunnel for avoiding axillary nerve injuries during arthroscopic transosseous rotator cuff repair: a magnetic resonance imaging-based simulation study. Orthop J Sports Med. 2018; 9; 6(11):2325967118806295. [PMC6240968];
[DOI: 10.1177/2325967118806295]
26. Kuroda S, Ishige N, Mikasa M. Reply to the Letter to the Editor. Advantages of Arthroscopic Transosseous Suture Repair of the Rotator Cuff without the Use of Anchors. Clin Orthop Relat Res. 2014; 472(3): 1044-1045. [PMID: 24363188]; [PMCID: PMC3916621]; [DOI: 10.1007/s11999-013-3435-3]