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. 2014 Nov 10;3(6):e667-71.
doi: 10.1016/j.eats.2014.08.004. eCollection 2014 Dec.

Arthroscopic lamina-specific double-row fixation for large delaminated rotator cuff tears

Daisuke Mori  1 , Noboru Funakoshi  1 , Fumiharu Yamashita  1
Affiliations

Arthroscopic lamina-specific double-row fixation for large delaminated rotator cuff tears

Daisuke Mori et al. Arthrosc Tech. .

Abstract

Delamination is a commonly observed finding at the time of rotator cuff repair, but few studies have described the surgical techniques used for delaminated rotator cuff tears (RCTs) or their clinical outcomes. We developed a technique using a combination of a double row and an additional row, which we call lamina-specific double-row fixation, for large delaminated RCTs. The lamina-specific double-row technique is performed using an additional row (lamina-specific lateral row) of suture anchors placed between the typical medial and lateral rows of suture anchors. The technique is performed as follows: (1) medial-row sutures are passed through the inferior (articular-side) and superior (bursal-side) layers in a mattress fashion; (2) lamina-specific lateral-row simple sutures are passed through the inferior layer; and (3) lateral-row simple sutures are passed through the superior layer. We believe that this technique offers the following advantages: (1) creation of a larger area of contact between the inferior layer and the footprint, (2) higher initial fixation strength of the articular-side components of the repaired rotator cuff tendon, and (3) an adaptation between the superficial and inferior layers. This technique represents an alternative option in the operative treatment of large delaminated RCTs.

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Figures

Fig 1
Fig 1
The inferior layer in delaminated RCTs can be grasped and pulled laterally to the footprint using a tendon grasper with a 7-mm bite after capsular release.
Fig 2
Fig 2
A right shoulder with large delaminated RCTs that underwent lamina-specific double-row fixation, as viewed from the posterolateral portal. (A) The edge of the inferior layer is retracted to the level of the glenoid. (B) Sutures of the medial row are placed through the inferior and superior layers in a mattress fashion. Simple sutures of the lamina-specific lateral row are placed through the inferior layer. (C) Knot tying for the lamina-specific lateral row is performed, and simple sutures of the lamina-specific lateral row are then placed through the superior layer. (D) Knot tying for the lateral simple sutures attached to the superior layer is performed, followed by knot tying for the medial row in a mattress fashion.
See this image and copyright information in PMC

Comment in

  • Lamina-Specific Double-Row Fixation of Rotator Cuff Tears.
    Osterhoff G, Hepp P. Osterhoff G, et al. Arthroscopy. 2015 Jun;31(6):1027. doi: 10.1016/j.arthro.2015.04.002. Arthroscopy. 2015. PMID: 26048760 No abstract available.
  • Authors' Reply.
    Mori D, Funakoshi N, Yamashita F. Mori D, et al. Arthroscopy. 2015 Jun;31(6):1027-8. doi: 10.1016/j.arthro.2015.04.003. Arthroscopy. 2015. PMID: 26048761 No abstract available.

References

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