Medialized Rip‐Stop Convergence Technique for Retracted Rotator Cuff Tears

Figures

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  Fig 1. In this left shoulder from a lateral subacromial viewing perspective in the beach-chair position, one can see a relatively large and medialized rotator cuff tendon tear.

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  Fig 2. Attempts at reducing the rotator cuff tissue with an arthroscopic soft-tissue grasper in this left shoulder viewing from a lateral subacromial viewing perspective in the beach-chair position. This demonstrates that this is a retracted and relatively immobile tear that can be reduced but only with relatively high tension.

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  Fig 3. Medialized humeral rotator cuff footprint in this left shoulder from a lateral subacromial viewing perspective in the beach-chair position.

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  Fig 4. Left shoulder from a lateral subacromial viewing perspective in the beach-chair position. One triple-loaded anchor is placed in the medialized tuberosity and the awl is positioned for placement of the second triple-loaded anchor. A single-row rip-stop construct configuration was used with a combination of mattress and simple sutures with simple sutures passed more medially than the mattress sutures.

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  Fig 5. An illustration of the single-row rip-stop suture configuration with the mattress suture (blue) with both limbs passed and the 2 simple sutures (green and red, respectively) with one limb that is passed and must be passed more medially than the mattress suture limbs (A). An illustration of the sutures of the rip stop configuration tied. Note that the horizontal mattress suture (blue) is tied first, followed by the simple sutures (green and red, respectively) (B).

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  Fig 6. Left shoulder from a lateral subacromial viewing perspective in the beach chair position. One limb of a simple suture from the more posterior anchor has been passed through the detached, medialized cuff and the other limb of that simple suture has been passed through the intact cuff to converge the intact cuff with the detached, medialized cuff.

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  Fig 7. The single-row rip stop configuration seen in this left shoulder from a lateral subacromial viewing perspective. Note there is some exposed tuberosity because of the medialization that was intentionally incorporated into this rotator cuff repair construct.