Multi-Suture Technique for Open Rotator Cuff Reconstruction

Abstract

Summary: Rotator cuff reconstruction associated with inferior acromioplasty is an effective treatment for the patient with a full-thickness rotator cuff tear. This article describes the author’s technique of using multiple sutures to reconstruct the torn rotator cuff tendon. Intuitively, it is felt that this multi-suture technique will distribute forces across the tendon better than will fewer, larger sutures. The author has published a comprehensive review of 72 patients treated with this technique and evaluated at a minimum follow-up of 2 years (range, 24–102 months). The mean age was 58 years (range, 24–87 years). At follow-up 82% of the patients rated their pain as <2 on a 0—10 visual analog scale, with “0” representing no pain. Ninety-six percent of the patients had no pain or slight pain without restriction of their activities of daily living. Ninety-four percent of the patients were subjectively satisfied with their surgical result. The mean UCLA scoring scale was 32 (range, 7–35). The mean Hospital for Special Surgery Scale was 94 and the mean raw Constant–Murley Score was 78 points (range, 12–95). This modification of the “classic” rotator cuff reconstruction yields predictable results and can be adapted to mini-open rotator cuff reconstruction. Although marked technologic changes have enhanced our ability to address rotator cuff disease arthroscopically, open rotator cuff reconstruction should remain a choice of the shoulder surgeon. HISTORICAL PERSPECTIVE