Clinical and Economic Advantages of Anchorless Arthroscopic Transosseous Suture Repair of the Rotator Cuff

Abstract

In 2005, an anchorless technique was developed for arthroscopic transosseous rotator cuff repair to reproduce open surgery. Since May 2015, the retear rate has decreased with the use of absorbable sutures in mattress suturing. This study analyzed 389 patients who underwent surgery using absorbable mattress sutures. Three 2-mm Kirschner wires with perforated tips were inserted through the inferior margin of the greater tuberosity into the medial edge of the footprint. After pulling the rotator cuff stump laterally, three Kirschner wires were penetrated through the rotator cuff and skin. Two glycolic acid and three polyester sutures were passed through three bone tunnels using the perforated tips of the Kirschner wires. Surgery was completed by inserting two absorbable mattress sutures and three nonabsorbable bridging sutures. The retear rate after surgery with absorbable mattress sutures was 1.8%. The cost of surgical materials used in our procedure was $12. The application of an absorbable suture in mattress suturing was associated with a low retear rate. Further, this technique only requires sutures. Hence, it is considered economically advantageous.