Arthroscopic Knotless-Anchor Rotator Cuff Repair

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Arthroscopic Techniques

Background:

• Rotator cuff tears, particularly of the supraspinatus tendon, are common.
• Arthroscopic rotator cuff repair is an established treatment.
• Double-row techniques aim for complete cuff footprint coverage.

Purpose of the Study:

• To describe the arthroscopic knotless, bridging, double-row, transosseous-equivalent rotator cuff repair technique.
• To compare the outcomes of knotless versus knot-tying rotator cuff repair.

Main Methods:

• Arthroscopic procedure in beach-chair position using lateral portals.
• Medial row anchor placement, tendon perforation with suture passer, and bridging to lateral row anchors.
• Key steps include diagnostic arthroscopy, debridement, decortication, anchor placement, suture passage, fixation, and acromioplasty.

Main Results:

• Knotless repair reduces medial strangulation and surgical time.
• No significant differences in clinical results or tendon integrity compared to knot-tying.
• Lower rate of medial cuff failure observed with knotless procedures.

Conclusions:

• The arthroscopic knotless, bridging, double-row, transosseous-equivalent technique is an effective alternative.
• This technique offers comparable clinical outcomes to knot-tying repairs.
• Knotless repair is associated with a reduced rate of medial cuff failure.