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Updated: Mar 6, 2026

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
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Reusable Instrumentation for Arthroscopic Rotator Cuff Repair May Not Impact Clinical Outcomes.

Seyedeh Zahra Mousavi1, Prasenjit Saha, Steve S Li

  • 1From the Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD (Ms. Mousavi, Dr. Saha, Dr. Li, Dr. Fox, Dr. Schmucker, and Dr. Srikumaran), and the Department of Orthopaedic Surgery, Riverside University Health Systems, Moreno Valley, CA (Dr. Haft).

Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews
|March 4, 2026
PubMed
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Reusable instruments for arthroscopic rotator cuff repair (RCR) show similar safety and effectiveness compared to disposable ones. This sustainable alternative reduces hospital waste without compromising patient outcomes.

Area of Science:

  • Orthopedic Surgery
  • Environmental Sustainability in Healthcare
  • Surgical Instrumentation

Background:

  • Hospitals generate significant waste, with operating rooms being major contributors.
  • Arthroscopic rotator cuff repair (RCR) commonly uses disposable instruments to prevent infection.
  • Limited data exists on the clinical safety of disposable vs. reusable instruments for RCR.

Purpose of the Study:

  • To evaluate if reusable instrumentation for arthroscopic RCR impacts clinical outcomes.
  • To compare infection and revision rates between reusable and disposable instrument cohorts.

Main Methods:

  • A retrospective cohort study of 191 patients undergoing primary arthroscopic RCR.
  • Patients were divided into reusable (N=89) and disposable (N=102) instrumentation groups.

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  • Primary outcomes: postoperative soft-tissue infection and septic revision within 1 year; analyzed using frequentist and Bayesian methods.

    • Main Results:

    • Similar infection and septic revision rates between reusable and disposable groups (1 septic revision each; P=1.0).
    • Aseptic revision rates were also comparable (P=0.50).
    • Surgical times did not significantly differ; Bayesian analysis confirmed no meaningful difference in infection risk.

    Conclusions:

    • Reusable instruments appear to be a safe alternative for arthroscopic RCR.
    • Findings suggest reusable instruments can be a sustainable option, reducing hospital environmental impact.
    • Further multisite studies are needed to confirm noninferiority due to the rarity of complications.