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Fundamentals in rotator cuff repair and reconstruction from world-renowned experts!
Rotator cuff disorders are the most common cause of shoulder pain, accounting for up to 70% of cases. Tears are the most severe subtype, with a lifetime prevalence rate of more than 20%. The size, location, and severity of rotator cuff tears varies greatly, requiring equally diverse preoperative planning and surgical interventions. Video Atlas of Arthroscopic Rotator Cuff Repair by Uma Srikumaran and esteemed contributors provides a concise, well-rounded perspective on the surgical management of rotator cuff pathologies.
Expert surgeons from across the globe describe and demonstrate numerous approaches, enabling clinicians to expand their armamentarium and achieve optimal outcomes. The opening chapters lay a solid foundation, covering basic techniques for arthroscopic repair of various rotator cuff tear patterns, patient positioning, portal placement, tips and tricks, complications, and pitfalls. Subsequent chapters succinctly discuss a comprehensive range of arthroscopic and transosseous techniques, biologic augmentation, grafting, tendon transfers, and superior capsular reconstruction.
Key Features
This is a must-have resource for orthopaedic surgery residents and fellows, especially shoulder and sports injury specialists.
This book includes complimentary access to a digital copy on https://medone.thieme.com.
1 Single-Row Rotator Cuff Repair Using Graft Augmentation and Bone Marrow Aspirate Concentrate Augmentation2 SCOI Row Rotator Cuff Repair-A Medial Row, Tension-Free, Triple-Loaded, Crimson Duvet-Augmented Rotator Cuff Repair3 Single-Row Undersurface All-Inside Rotator Cuff Repair4 Double-Row Repair with Biceps Tendon Augmentation5 Double Row with "Rip-Stop" Rotator Cuff Repair6 SpeedBridge Repair of Massive Rotator Cuff Tears Using Provisional Traction Suture Reducing Anchor and Bioinductive Bovine Augment Patch7 Two-Anchor, Double-Row Rotator Cuff Repair with Incorporated Biceps Tenodesis8 Arthroscopic Transosseous Equivalent Rotator Cuff Repair: Key Points of Surgical Technique9 Arthroscopic Double-Row Transosseous Equivalent Repair of Large Rotator Cuff Tears10 Arthroscopic Rotator Cuff Repair Using a Suture-Bridge Technique and Associated Open Subpectoral Biceps Tenodesis11 Transosseous Repair12 True Transosseous Hybrid Rotator Cuff Repair13 All-Arthroscopic Anchorless Transosseous Rotator Cuff Repair14 Fully Arthroscopic Transosseous Rotator Cuff Repair: A Reverse-Guided Technique15 Double-Row Subscapularis Repair for Full-Thickness Subscapularis Tears16 Arthroscopic Single-Row Subscapularis Tendon Repair17 Arthroscopic Single Row Subscapularis Repair18 Arthroscopic Repair of Subscapularis Tear Based on the Tear Types19 Arthroscopic Transtendon Double-Row Subscapularis Repair with all Suture Medial Row Anchors20 Four-Anchor Repair of Massive Subscapularis Tear with Subcoracoid Decompression21 Superior Capsular Reconstruction with Fascia Lata Autograft22 Superior Capsular Reconstruction with Allograft23 Superior Capsular Reconstruction with Porcine Xenograft24 All-Arthroscopic Superior Capsular Reconstruction with Dermal Allograft25 Subpectoral Biceps Tenodesis26 Identifying and Exposing the Proximal Biceps in Its Groove: The "Slit" Technique27 Arthroscopic Suprapectoral Biceps Tenodesis with Lasso Loop28 Transosseous Arthroscopic Biceps Tenodesis29 Revision Rotator Cuff Repair and Techniques for Mobilization30 Arthroscopic Transosseous Revision Rotator Cuff Repair31 Biological Augmentation of Rotator Cuff Repair with Platelet-Rich Plasma and Multiple Channeling32 Load-Sharing Rip-Stop and Knotless Rip-Stop Repairs for Massive Rotator Cuff Tears33 Arthroscopically Assisted Lower Trapezius Transfer for Irreparable Posterosuperior Rotator Cuff Tears34 Subacromial Balloon Spacer for Irreparable Cuff Tears35 Acellular Human Dermal Allograft Rotator Cuff Reconstruction36 A Comparison of the Outcomes of Two Types of Synthetic Patches for Interpositional Graft Use in Irreparable Rotator Cuff Tears37 Dermal Augmentation for Challenging Large and Massive Rotator Cuff Tears38 Case Discussions on Surgical Decision Making for Massive Rotator Cuff Tears: Repair, Reconstruction, or Reverse Shoulder Replacement?
Video 1.1: Single-row rotator cuff repair using graft augmentation and bone marrow aspirate concentrate augmentation.
Video 3.1: Introduction and rationale for the single-row undersurface all-inside rotator cuff repair.
Video 3.2: Demonstration of complete technique for the single-row undersurface all-inside rotator cuff repair.
Video 3.3: Unedited 4 minute repair using the single-row undersurface all-inside technique.
Video 4.1: Demonstration of a rotator cuff tear with additional strain on the supraspinatus portion of the repair and repair with our described augmentation technique. The tenotomized biceps tendon can be used as a bridge to increase the greater tuberosity coverage and reduce the tension of the repair. The anterior portion of the repair is reinforced with the anchor tenodesis and the posterior cable is reinforced with the free edge of the biceps fixed to the infraspinatus. The posterior unit is further secured with a double row transosseous equivalent fixation.
Video 5.1: Surgical demonstration of a double row with "rip-stop" rotator cuff repair.
Video 6.1: Arthroscopic view from the posterolateral portal of a large to massive tear. After extensive subacromial bursectomy and rotator cuff tissue releases, an anterior leading edge traction suture is placed in a luggage tag fashion. This is then reduced down to the footprint with a 4.75 Swivel Lock (Arthrex) anchor. A smaller U-shape tear is now visualized. The medial row anchors of the speed bridge repair are placed. The suture limbs are passed through the cuff with a medial seal stitch performed with use of the sliding fiberwire sutures. Once the medial seal stitch is fixated down to the rotator cuff tissue, the lateral row anchors are placed completing the speed bridge repair. The bioinductive patch is then inserted subacromially with the delivery device. The medial end of the patch is fixated to the rotator cuff tissue with use of bioabsorbable staples. It is then fixated laterally with bone staples completing the procedure.
Video 7.1: This video demonstrates an arthroscopic rotator cuff repair and biceps tenodesis in a right shoulder in the beach chair position, utilizing a two-anchor double-row rotator cuff repair with incorporated biceps tenodesis.
Video 8.1: This video details the surgical technique of arthroscopic single row, transosseous equivalent (tension band) rotator cuff repair.
Video 9.1: Surgical demonstration of an arthroscopic double-row transosseous equivalent repair of a large rotator cuff tear.
Video 10.1: Surgical demonstration featuring transosseous equivalent arthroscopic repair of the supraspinatus tendon followed by open subpectoral biceps tenodesis.
Video 11.1: Surgical demonstration of an arthroscopic transosseous rotator cuff repair technique.
Video 12.1: True transosseous hybrid arthroscopic cuff repair of a right shoulder is shown in the beachair position. This technique offers triple row fixation, no inert material at the healing interface, decreased cost per fixation point, cortical augmentation, and the chance to retension the construct at the final step.
Video 13.1: Surgical demonstration of an all-arthroscopic transosseous rotator cuff repair.
Video 14.1: Surgical demonstration of fully arthroscopic transosseous rotator cuff repair: a reverse-guided technique.
Video 15.1: The patient was placed in the beach chair position. A standard posterior portal was established followed by anterior, direct lateral, and anterosuperior under direct visualization. If significant adhesions are present, dissection of the axillary nerve may be necessary. To improve visualization, the biceps tendon was amputated and coracoplasty is performed with a 4.0-mm arthroscopic burr. The subscapularis was mobilized and the tendon approximated with an arthroscopic grasper. The footprint was prepared with an electrothermal device and 4.0-mm arthroscopic burr. The inferior medial-row anchor was placed. The suture was passed with a suture-passing device through the subscapularis in a medial to lateral angle. The superior medial anchor was placed next. Superior sutures were passed in a similar fashion. A superior mattress stitch may be placed. The bicipital groove was prepared with an electrothermal device and arthroscopic burr. A superior and inferior lateral row anchor was placed in the bicipital groove approximately 1cm apart. Final fixation was performed through arthroscopic knot tying.
Video 16.1: Surgical demonstration of an arthroscopic single-row subscapularis tendon repair technique.
Video 17.1: Surgical demonstration of an arthroscopic single-row subscapularis tendon repair technique.
Video 18.1: Arthroscopic repair of subscapularis tear based on the tear types and biological augmentation of rotator cuff repair with platelet-rich plasma and multiple channeling.
Video 19.1: This video demonstrates our preferred technique for arthroscopic transtendon double-row subscapularis repair. The procedure is on the patient's right shoulder in a beach chair position. The initial view is with a 30 degree lens from a posterior viewing portal. The subscapularis tear is identified and mobilized. Once adequately mobilized the insertion site is prepared and the tendon is held in a reduced position while medial row anchors are placed transtendon. The repair construct is completed using a medial double pulley to compress the tendon and a lateral row in a speed-bridge configuration.
Video 20.1: Preparation, technique, and rehabilitation for the management of a massive subscapularis tendon tear, including a subcoracoid decompression.
Video 21.1: Surgical demonstration of measurement of defect size.
Video 21.2: Surgical demonstration of acromioplasty.
Video 21.3: Surgical demonstration of glenoid anchor insertion.
Video 21.4: Surgical demonstration of greater tuberosity anchor insertion.
Video 21.5: Surgical demonstration of graft insertion and fixation.
Video 22.1: Accompanying video of our preferred superior capsular reconstruction technique with dermal allograft. Individual surgical steps are detailed in the video captions.
Video 23.1: Preparatory steps and anchor placement.
Video 23.2: Graft placement, lateral row fixation and posterior side to side repair.
Video 24.1: Surgical demonstration of all-arthroscopic superior capsular reconstruction with dermal allograft.
Video 25.1: Surgical demonstration of a subpectoral biceps tenodesis with an all-suture double-loaded anchor.
Video 26.1: Surgical demonstration of identifying and exposing the proximal biceps in Its groove: the "slit" technique.
Video 27.1: Surgical demonstration of arthroscopic suprapectoral biceps tenodesis with lasso loop.
Video 28.1: Arthroscopic transosseous biceps tenodesis is demonstrated in the right shoulder in beach chair position. The biceps is secured with multi-point cerclage suture fixation in the suprapectoral location at physiologic length and tension in anchorless fashion.
Video 29.1: Surgical demonstration of revision rotator cuff repair and techniques for mobilization.
Video 30.1: Arthroscopic transosseous revision rotator cuff repair.
Video 31.1: Video of rotator cuff repair with microchanneling and PRP augmentation.
Video 32.1: Surgical demonstration of load-sharing rip-stop.
Video 32.2: Surgical demonstration of knotless rip-stop.
Video 33.1: Surgical demonstration of arthroscopically assisted lower trapezius transfer for irreparable posterosuperior rotator cuff tears.
Video 34.1: Description of the balloon with arthroscopic placement.
Video 35.1: Surgical demonstration of acellular human dermal allograft rotator cuff reconstruction.
Video 36.1: Surgical demonstration of a comparison of the outcomes of two types of synthetic patches for interpositional graft use in irreparable rotator cuff tears.
Video 38.1: Case discussion and surgical demonstration of reverse shoulder arthroplasty in an 80 year old male with a large superior, retracted rotator cuff tear.
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