Arthroscopy Technique: Repair of Musculotendinous Junction Rotator Cuff Tears in the Shoulder Using a Dynamic Convergence Suture Bridge Technique
Musculotendinous junction (MTJ) rotator cuff tears in the shoulder are rare injuries in which the tendon fails medial to its tuberosity attachment. There is difficulty in striking a balance between restoring the length–tension relationship of the tendon while avoiding high suture tension at the repa...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Arthroscopy Techniques |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212628723002281 |
| _version_ | 1797378772698136576 |
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| author | Cheryl Gatot, M.B.B.S. Hannah Mei En Lie, M.B.B.S. Denny Lie Tijauw Tjoen, M.B.B.S., F.R.C.S. (Edin), F.A.M.S. |
| author_facet | Cheryl Gatot, M.B.B.S. Hannah Mei En Lie, M.B.B.S. Denny Lie Tijauw Tjoen, M.B.B.S., F.R.C.S. (Edin), F.A.M.S. |
| author_sort | Cheryl Gatot, M.B.B.S. |
| collection | DOAJ |
| description | Musculotendinous junction (MTJ) rotator cuff tears in the shoulder are rare injuries in which the tendon fails medial to its tuberosity attachment. There is difficulty in striking a balance between restoring the length–tension relationship of the tendon while avoiding high suture tension at the repair site. In view of the rare incidences of these tears, there is a paucity of literature on their repair techniques. We seek to share our surgical technique in addressing type A MTJ tears—where the medial muscular tear margin is short but remains adequate for suture bridge repair, whereas the lateral tendon remains on the footprint. We used mattress sutures from the medial row of anchors, threaded through the lateral tendon stump, then passed medially to engage the medial stump, before being fixed to a lateral row in a knotless fashion. Pulling on this pair of sutures will thus bring into closer apposition of both medial and lateral tear margins in a dynamic convergence pattern. Our surgical technique is a safe and effective method of repairing type A MTJ tear that confers improved biological and biomechanical advantage via the formation of a dynamic convergence suture bridging technique in addition to a double-row repair construct. |
| first_indexed | 2024-03-08T20:12:27Z |
| format | Article |
| id | doaj.art-c7e8b2bc58874f88b08a377e4862b591 |
| institution | Directory Open Access Journal |
| issn | 2212-6287 |
| language | English |
| last_indexed | 2024-03-08T20:12:27Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy Techniques |
| spelling | doaj.art-c7e8b2bc58874f88b08a377e4862b5912023-12-23T05:20:36ZengElsevierArthroscopy Techniques2212-62872023-12-011212e2117e2126Arthroscopy Technique: Repair of Musculotendinous Junction Rotator Cuff Tears in the Shoulder Using a Dynamic Convergence Suture Bridge TechniqueCheryl Gatot, M.B.B.S.0Hannah Mei En Lie, M.B.B.S.1Denny Lie Tijauw Tjoen, M.B.B.S., F.R.C.S. (Edin), F.A.M.S.2Department of Orthopaedic Surgery, Singapore General Hospital, Singapore; Address correspondence to Cheryl Gatot, Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore 169856.Lee Kong Chian School of Medicine, Nanyang Technological University, SingaporeDepartment of Orthopaedic Surgery, Singapore General Hospital, SingaporeMusculotendinous junction (MTJ) rotator cuff tears in the shoulder are rare injuries in which the tendon fails medial to its tuberosity attachment. There is difficulty in striking a balance between restoring the length–tension relationship of the tendon while avoiding high suture tension at the repair site. In view of the rare incidences of these tears, there is a paucity of literature on their repair techniques. We seek to share our surgical technique in addressing type A MTJ tears—where the medial muscular tear margin is short but remains adequate for suture bridge repair, whereas the lateral tendon remains on the footprint. We used mattress sutures from the medial row of anchors, threaded through the lateral tendon stump, then passed medially to engage the medial stump, before being fixed to a lateral row in a knotless fashion. Pulling on this pair of sutures will thus bring into closer apposition of both medial and lateral tear margins in a dynamic convergence pattern. Our surgical technique is a safe and effective method of repairing type A MTJ tear that confers improved biological and biomechanical advantage via the formation of a dynamic convergence suture bridging technique in addition to a double-row repair construct.http://www.sciencedirect.com/science/article/pii/S2212628723002281 |
| spellingShingle | Cheryl Gatot, M.B.B.S. Hannah Mei En Lie, M.B.B.S. Denny Lie Tijauw Tjoen, M.B.B.S., F.R.C.S. (Edin), F.A.M.S. Arthroscopy Technique: Repair of Musculotendinous Junction Rotator Cuff Tears in the Shoulder Using a Dynamic Convergence Suture Bridge Technique Arthroscopy Techniques |
| title | Arthroscopy Technique: Repair of Musculotendinous Junction Rotator Cuff Tears in the Shoulder Using a Dynamic Convergence Suture Bridge Technique |
| title_full | Arthroscopy Technique: Repair of Musculotendinous Junction Rotator Cuff Tears in the Shoulder Using a Dynamic Convergence Suture Bridge Technique |
| title_fullStr | Arthroscopy Technique: Repair of Musculotendinous Junction Rotator Cuff Tears in the Shoulder Using a Dynamic Convergence Suture Bridge Technique |
| title_full_unstemmed | Arthroscopy Technique: Repair of Musculotendinous Junction Rotator Cuff Tears in the Shoulder Using a Dynamic Convergence Suture Bridge Technique |
| title_short | Arthroscopy Technique: Repair of Musculotendinous Junction Rotator Cuff Tears in the Shoulder Using a Dynamic Convergence Suture Bridge Technique |
| title_sort | arthroscopy technique repair of musculotendinous junction rotator cuff tears in the shoulder using a dynamic convergence suture bridge technique |
| url | http://www.sciencedirect.com/science/article/pii/S2212628723002281 |
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