Anchorless Arthroscopic Transosseous Rotator Cuff Repair

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Rotator cuff repair (RCR) techniques have evolved from open procedures to arthroscopic methods using anchors and implants.
• Current advancements favor arthroscopic transosseous repair, an anchor-free technique.
• This evolution aims to improve biomechanical strength and anatomical restoration.

Purpose of the Study:

• To demonstrate the essential steps of arthroscopic transosseous rotator cuff repair (ATRCR).
• To highlight the advantages of ATRCR over traditional methods.
• To emphasize the goal of anatomical restoration and enhanced healing.

Main Methods:

• Utilizing a 4-portal arthroscopy technique for optimal visualization and instrumentation.
• Performing a limited bursectomy to preserve growth factors and minimize tuberosity trauma.
• Creating transosseous tunnels with a wide bone bridge and triple-loading them with high-strength sutures.

Main Results:

• Studies show high success rates for ATRCR, with mean ASES scores around 92-95 and low failure rates (3.7%-27%) in mid- to long-term follow-up.
• Benefits include decreased healthcare costs and postoperative pain.
• ATRCR achieves strong initial fixation and anatomic footprint restoration, maximizing biological healing potential.

Conclusions:

• Arthroscopic transosseous rotator cuff repair provides strong fixation and anatomical restoration without anchors.
• This technique maximizes biomechanical strength and promotes biological healing.
• ATRCR represents a significant advancement in rotator cuff repair surgery.