前十字靭帯ジグを用いた関節鏡視下アンカーレス回旋腱板修復術（「Jテクニック」）：費用対効果の高い代替法

Rotator cuff tears are a common cause of shoulder disability, often requiring surgical repair. The high cost of suture anchors presents a significant economic burden, driving the need for cost-effective alternatives like transosseous repairs. This paper details a novel arthroscopic anchorless technique utilizing an anterior cruciate ligament (ACL) jig with the "J Technique" to provide a biomechanically sound and economically advantageous solution.

We present a technique for arthroscopic anchorless rotator cuff repair (RCR). Standard arthroscopic portals are established. An ACL jig is introduced to guide the creation of a precise transosseous tunnel in the greater tuberosity using a 4.5 mm cannulated reamer. Suture strands (FiberWire and FiberTape) are passed through the tunnel and the rotator cuff tendon. The sutures are tied with SMC sliding knots, strategically placing the post to ensure knots settle at the lower tunnel exit, forming an inverted "J" configuration that secures the tendon to its footprint.

The arthroscopic anchorless "J Technique" using an ACL jig is a reproducible and cost-effective surgical alternative for RCR. It provides robust fixation, minimizes hardware-related risks, and prevents subacromial impingement through strategic knot management, offering a valuable option for surgeons seeking to control costs without compromising stability.