Abstract
BackgroundWe present a simple technique of arthroscopic rotator cuff repair using a spinal needle and suture loop.MethodsWith the arthroscope laterally, a spinal needle looped with PDS is inserted percutaneously into the shoulder posteriorly and penetrated through the healthy posterior cuff tear margin. Anteriorly, another spinal needle loaded with PDS is inserted percutaneously to engage the healthy tissue at the anterior tear margin. The suture in the anterior needle is then delivered into the suture loop of the posterior needle using a suture retriever. The posterior needle and loop are then pulled out carrying the anterior suture with it. The two limbs of this suture are then retrieved through a cannula for knotting. The same procedure is then repeated for additional suturing. Suture anchors placed over the greater tuberosity are used to complete the repair.ConclusionThis is an easy method of rotator cuff repair using simple instruments and lesser time, hence can be employed at centers with less equipment and at reduced cost to the patient.
Highlights
We present a simple technique of arthroscopic rotator cuff repair using a spinal needle and suture loop
The commonly used methods in the U- or L-shaped tears employ either the 2-step or the 1-step techniques [1]. In the former, the sutures are passed through each cuff margin one at a time and in the latter, through both margins simultaneously
Burkhart termed “margin convergence” to describe the observation that during side-to-side repair the surgeon can visualize the free margin of the tear converging toward the greater tuberosity with each suture being placed and that using margin convergence in the repair of U-shaped tears decreases the amount of strain at the tendon bone interface of the repair and should be protective to the tendon bone interface of the repair [1]
Summary
We present a simple technique of arthroscopic rotator cuff repair using a spinal needle and suture loop. Rotator cuff tears have been seen in this purview ever since Wolf [1,2,3,4] did the first all arthroscopic repair. Many techniques have been enumerated [3,5,6,8,9] and they require a long learning curve and numerous expensive instruments. The commonly used methods in the U- or L-shaped tears employ either the 2-step or the 1-step techniques [1]. In the former, the sutures are passed through each cuff margin one at a time and in the latter, through both margins simultaneously. The need is to have a technique combining the advantages of both that would be technically
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