Hi. I’m Doctor Vic Goradia. I’m a knee and shoulder specialist from G2 orthopedics and sports medicine in Richmond Virginia. I’m introducing a video on arthroscopic double row double rotator cuff repair.
This shows a fairly standard size rotator cuff tear that I’ve prepared anatomically, all arthroscopically.
In some cases people tear their rotator cuff to a lesser degree that can also be repaired arthroscopically. However, in some cases, people have very large and complicated rotator cuff tears that in many hands requires an open surgical procedure.
Based on my experience in the past 15 years repairing these types of tears, I’m able to repair almost all of them arthroscopically.
This diagram shows a torn rotator cuff here that is being grasped so that it can be re-attached back to the bone. Here’s the rotator cuff tear and this is where it normally attaches onto the bone.
I’m going to initially debried or clean up the edges of the rotator cuff so that we have healthy tissue to reattach. We’re also going to remove some of the soft tissue where the residual tissue on the bone, so that we have a healthy surface to reattach to.
This is a different view that shows the rotator cuff and underneath it you can actually see the humeral head and the gleno where the ball and socket.
We’re going to take an Arthrex scorpion device to pass suture through the torn rotator cuff. This is called a fibre link suture that will be used to pass the actual sutures and tape that we’re going to use for the repair.
This is a punch that we’re using to create a small hole in the bone so that we can insert an anchor. This Arthrex swivel lock anchor is a bio-composite material that will actually turn into bone over time.
It is pre-loaded with the blue thicker suture called fibre tape because it’s thicker than normal suture, it allows more surface area for fixation.
We’ve now passed the fibre tape suture through the torn rotator cuff. There’s the blue fibre tape, the suture that we’ve passed, and then we did a second anchor with the white fibre tape suture.
We have a small dog-ear of tissue left in the back here, so we’re going to put a fibre link through that dog ear that’ll help us to bring it down. So this is called our medial road in our double row repair.
I’m going to now take one white fibre tape and one blue fibre tape so that they criss-cross over top of the tissue of the rotator cuff, and we’ll bring it out into what’s called a lateral row for our double row repair.
We’re now using the same punch for the lateral row to create a small hole for our swivel lock anchor. We’ve passed the fibre tape through the island in the anchor and now we’re going to secure it down to the bone and create appropriate tension so I’m going to be able to tension each of the suture strands – we’ll see right there that I’ve pulled the blue a little bit tighter so that we have the appropriate tension. There we go again.
I’m going to screw in this bio-composite anchor – this will give us the first of our two lateral row anchors. Now we’re going to cut the excess suture material flush with the anchor.
We’re going to repeat the procedure and take the remaining sutures and secure them down into the bone. This creates a nice fixation for the rotator cuff.
So we have our torn rotator cuff that we have attached back to the bone in a double row configuration – we have a medial row and a lateral row.
And this is what it looks like – we have a medial row and a lateral row. And now we have secure fixation.