Arthroscopic Rotator Cuff Repair Using a Triple-Loaded Suture Anchor and a Modified Mason-Allen Technique (Alex Stitch)

Abstract Surgical repair of the rotator cuff must have good resistance and should restore the tendon footprint. To attain this goal, a stitch with a strong biomechanical profile that avoids tissue strangulation should be used. We describe an arthroscopic suture technique undertaken to repair rotator...

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Veröffentlicht in:Arthroscopy 2007-04, Vol.23 (4), p.440.e1-440.e4
Hauptverfasser: Castagna, Alessandro, M.D, Garofalo, Raffaele, M.D, Conti, Marco, M.D, Borroni, Mario, M.D, Snyder, Stephen J., M.D
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container_end_page 440.e4
container_issue 4
container_start_page 440.e1
container_title Arthroscopy
container_volume 23
creator Castagna, Alessandro, M.D
Garofalo, Raffaele, M.D
Conti, Marco, M.D
Borroni, Mario, M.D
Snyder, Stephen J., M.D
description Abstract Surgical repair of the rotator cuff must have good resistance and should restore the tendon footprint. To attain this goal, a stitch with a strong biomechanical profile that avoids tissue strangulation should be used. We describe an arthroscopic suture technique undertaken to repair rotator cuff tears with a single triple-loaded suture anchor. The technique consists of a combination of a horizontal mattress and 2 vertical simple sutures that are positioned medial to the mattress suture. The suture anchor used is the 5-mm self-tapping ThRevo (Linvatec). This anchor is loaded with 3 sutures: 2 No. 2 nonabsorbable braided polyester sutures of different colors and a central high-strength No. 2 polyethylene suture. The shape of the anchor eyelet permits all 3 sutures to glide freely. A modified Mason-Allen technique (Alex stitch) that combines a horizontal side-to-side suture and 2 simples sutures as vertical loops is used. With use of the Spectrum suture passing device and shuttle relay system (Linvatec), both limbs of the centrally located polyethylene suture are passed through the cuff from bottom to top, approximately 1 cm from the tendon edge. This suture is not immediately tied. Next, with use of the same system, the other 2 sutures are placed medially and over the previous horizontal suture. Simple sutures are placed at an approximately 30° angle from the center of the anchor; 1 is placed anterior and the other posterior. The sutures are tied through the lateral portal. The mattress horizontal central stitch is always tied first, followed by the 2 vertical sutures. The horizontal mattress suture serves as a “rip stop stitch” and theoretically reduces the possibility of cutting out of the simple sutures.
doi_str_mv 10.1016/j.arthro.2006.07.046
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With use of the Spectrum suture passing device and shuttle relay system (Linvatec), both limbs of the centrally located polyethylene suture are passed through the cuff from bottom to top, approximately 1 cm from the tendon edge. This suture is not immediately tied. Next, with use of the same system, the other 2 sutures are placed medially and over the previous horizontal suture. Simple sutures are placed at an approximately 30° angle from the center of the anchor; 1 is placed anterior and the other posterior. The sutures are tied through the lateral portal. The mattress horizontal central stitch is always tied first, followed by the 2 vertical sutures. 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subjects Alex stitch
Arthroscopy
Arthroscopy - methods
Biological and medical sciences
Cohort Studies
Endoscopy
Female
Follow-Up Studies
Footprint
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Minimally Invasive Surgical Procedures - methods
Modified Mason-Allen technique
Orthopedic surgery
Orthopedics
Range of Motion, Articular - physiology
Recovery of Function
Risk Assessment
Rotator Cuff - surgery
Rotator cuff repair
Shoulder
Shoulder Joint - physiopathology
Shoulder Joint - surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Suture Anchors
Suture Techniques
Tensile Strength
Treatment Outcome
Triple-loaded suture anchor
title Arthroscopic Rotator Cuff Repair Using a Triple-Loaded Suture Anchor and a Modified Mason-Allen Technique (Alex Stitch)
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