Arthroscopic Rotator Cuff Repair: Double-Row Suture Anchor Technique

Laurent Lafosse, MD and Reuben Gobezie, MD

Several investigators have studied the clinical outcomes after arthroscopic rotator cuff repair and have reported that the short-term clinical outcomes are comparable with those of the traditional open and mini-open repair techniques. More recently, investigators have attempted to correlate the integrity of the arthroscopic repair with postoperative function and have demonstrated widely varying results, with generally high failure rates. All of those previous studies were performed with use of a simple single-row suture repair technique.

The concerns raised in those reports about repair integrity after arthroscopic surgery have resulted in a number of studies designed to analyze various repair techniques. Specifically, those studies have evaluated the biomechanical strength, contact area, and failure modes of single-row suture anchor, double-row suture anchor, and transosseous repairs performed with various suturing patterns in relation to their ability to restore the native rotator cuff footprint. One of the implications of those studies and recent reports on double-row suture anchor fixation is that the repair techniques that are better able to restore the normal footprint of the rotator cuff will be stronger and have the best chance for healing because of the larger contact area. The purpose of the study published in JBJS by Lafosse, et.al. was to evaluate the short-term results of arthroscopic repair with use of the double-row suture anchor technique and to correlate these results with the integrity of the rotator cuff as determined with postoperative arthrography.

The authors conclude the double-row suture anchor technique for arthroscopic rotator cuff repair resulted in superior tendon healing as compared with previously studied open and other arthroscopic methods of repair. Intact rotator cuff repairs resulted in markedly improved pain relief in comparison with repairs that failed or only partially healed. Shoulders with repaired large and massive rotator cuff tears had less strength than those with smaller tears. These findings suggest that the double-row suture anchor configuration may be the optimal repair construct for arthroscopic rotator cuff repair, although long-term studies will be needed to validate this concept.

In this JBJS/VJO video supplement to the article, Laurent Lafosse, MD and Reuben Gobezie, MD demonstrate and discuss their technique.

Material Covered

  • Portal Placement
  • Balloon Exposure Technique
  • Double Row Suture Anchor Technique
  • Acromioplasty
  • Surgical Pearls
  • Avoiding Complications
Click on any of the images below for a larger view:

See the Corresponding JBJS Article:
Laurent Lafosse, Roman Brozska, Bruno Toussaint, and Reuben Gobezie
The Outcome and Structural Integrity of Arthroscopic Rotator Cuff Repair with Use of the Double-Row Suture Anchor Technique
J. Bone Joint Surg. Am., Jul 2007; 89: 1533 – 1541 [Article]
Laurent Lafosse, Roman Brzoska, Bruno Toussaint, and Reuben Gobezie
The Outcome and Structural Integrity of Arthroscopic Rotator Cuff Repair with Use of the Double-Row Suture Anchor Technique. Surgical Technique
J. Bone Joint Surg. Am., Oct 2008; 90: 275 – 286. [Article]
Specifications
  • Total Run Time: 68:32 minutes
  • Catalog Number: 7066
  • VJO Publication Date: June, 2008