Arthroscopic Rotator Cuff Surgery (eBook)

Foreword 6
Preface 8
Contents 10
Contributors 14
Surgical Indications and Repairability of Rotator Cuff Tears 18
1.1. Assessing Rotator Cuff Tear Repairability 19
1.2. Indications and Timing for Surgical Repair 22
1.3. Enhancing Rotator Cuff Tear Repairability 26
1.4. Conclusions 28
Making the Transition from Mini- Open to All- Arthroscopic Repair 32
2.1. General Approach to the Transition 32
2.2. Indications and Contraindications 33
2.3. Preoperative Planning 34
2.4. Surgical Procedure 34
2.5. Postoperative Management 38
2.6. Results and Complications 39
2.7. Conclusions 40
Patient Positioning, Anesthesia Choices, and Portals 42
3.1. Patient Positioning 42
3.2. Anesthesia Choices 43
3.3. Portals 45
3.4. Conclusions 50
Suture Anchor Options 51
4.1. Anchor Evaluation 52
4.2. Anchor Size 53
4.3. Anchor Shape 53
4.4. Anchor Eyelet 54
4.5. Suture Material 55
4.6. Anchor Material and Anchor Removal 55
4.7. Anchor Placement 56
4.8. Anchor Failure 57
4.9. Rehabilitation 57
4.10. Current Anchor Developments 58
Suture Management and Passage 72
5.1. Retrograde Suturing 72
5.2. Antegrade Suturing 75
5.3. Side– Side Suturing 79
5.4. Conclusions 84
Arthroscopic Knot Tying 85
6.1. Knot Definitions 85
6.2. Knots To Know 86
6.3. Tying a Surgeon’s Knot (Static Knot) 88
6.4. Tying the Roeder Knot (Sliding Knot) 93
6.5. Practical Tips When Tying an Arthroscopic Knot 97
6.6. Conclusions 99
Role of Arthroscopic Decompression and Partial Clavicle Resection 100
7.1. Historical Perspective 100
7.2. Etiology and Type of Impingement 101
7.3. Athroscopic Subacromial Decompression Controversies and Indications 103
7.4. Acromioclavicular Controversies and Indications 105
7.5. Anatomy 106
7.6. Diagnosis 107
7.7. Preoperative Planning 108
7.8. Surgical Procedure 109
7.9. Postoperative Management 117
7.10. Complications 117
7.11. Conclusions 118
Tendon-to- Tuberosity Repair: Medial Footprint Fixation 122
8.1. Indications and Contraindications 122
8.2. Preoperative Planning 123
8.3. Surgical Procedure 125
8.4. Surgical Technique 126
8.5. Postoperative Management 133
8.6. Results and Complications 133
Tendon-to- Tuberosity Repair: Lateral Footprint Fixation 135
9.1. Indications and Contraindications 136
9.2. Preoperative Planning 136
9.3. Operative Technique 137
9.4. Postoperative Management 141
9.5. Results and Complications 142
9.6. Conclusions 142
Tendon-to- Tuberosity Repair: Double Row Fixation 144
10.1. Indications and Contraindications 148
10.2. Preoperative Planning 149
10.3. Surgical Procedure 149
10.4. Postoperative Management 157
10.5. Results and Complications 157
Partial Articular- Sided Tendon Avulsion Transtendon Rotator Cuff Repair 160
11.1. Treatment Classification 161
11.2. Patient Evaluation 162
11.3. Surgical Repair 162
11.4. Postoperative Management 168
11.5. Results 168
11.6. Conclusions 171
Suture Anchor Repair of Small and Medium Supraspinatus Tears 176
12.1. Indications and Contraindications 176
12.2. Surgical Procedure 177
12.3. Postoperative Management 184
12.4. Complications 189
Arthroscopic Repair of Subscapularis Tears 191
13.1. Anatomy and Endoscopy 191
13.2. Causes of Subscapularis Tendon Tear 195
13.3. Diagnosis and Evaluation 196
13.4. Surgical Procedure 196
13.5. Preoperative and Postoperative Clinical and Radiological Assessment 206
13.6. Classification 207
13.7. Clinical Results 207
13.8. Radiological Results 209
13.9. Complications 209
13.10. Comparison of Results with the Literature 209
13.11. Indications 210
13.12. Conclusions 211
Tendon Mobilization in Large Rotator Cuff Tears 212
14.1. Indications and Contraindications 212
14.2. Preoperative Planning 213
14.3. Surgical Procedure 214
14.4. Conclusions 223
Arthroscopic Rotator Cuff Repair with Interval Release for Contracted Rotator Cuff Tears 225
15.1. Surgical Procedure 225
15.2. Postoperative Management 233
When and How to Do Margin Convergence Repair Versus Interval Slides 235
16.1. Tear Pattern Recognition 235
16.2. Margin Convergence 237
16.3. Massive Contracted Immobile Rotator Cuff Tears 237
16.4. Conclusions 243
Repair of Large Anterosuperior Cuff Tears 245
17.1. Clinical Evaluation 246
17.2. Arthroscopic Evaluation 250
17.3. Surgical Technique 251
17.4. Results 257
17.5. Conclusions 261
Natural Extracellular Matrix Grafts for Rotator Cuff Repair 263
18.1. Biological Enhancement of Rotator Cuff Repair 264
18.2. Indications for Use of an Extracellular Matrix Graft 266
18.3. Regulatory Aspects 267
18.4. Specific Product Information 267
18.5. Comparison of Extracellular Matrix Biomaterials 270
18.6. Studies in Peer-Reviewed Literature 271
18.7. Conclusions 280
Biceps Tenotomy: Alternative When Treating the Irreparable Cuff Tear 286
19.1. Indications and Contraindications for Treatment 286
19.2. Preoperative Planning 287
19.3. Surgical Procedure 287
19.4. Postoperative Management 288
19.5. Results 291
19.6. Complications 291
Biceps Soft Tissue Tenodesis 293
20.1. Functional Anatomy of the Long Head of Biceps Tendon 294
20.2. Classification of Pathological Findings 295
20.3. Surgical Procedure 296
20.4. Postoperative Management 303
20.5. Conclusions 303
Biceps Tenodesis with Interference Screw 307
21.1. Indications and Contraindications 307
21.2. Preoperative Planning 308
21.3. Surgical Procedure 311
21.4. Postoperative Management 319
21.5. Results and Complications 319
21.6. Conclusions 321
Biceps Subpectoral Mini- Open Tenodesis 323
22.1. Indications and Contraindications 324
22.2. Preoperative Planning 324
22.3. Surgical Procedure 325
22.4. Postoperative Management 329
22.5. Results and Complications 329
22.6. Conclusions 332
Endoscopic Release of Suprascapular Nerve Entrapment at the Suprascapular Notch 335
23.1. Anatomy 336
23.2. Etiology 337
23.3. Diagnosis 337
23.4. Indications 338
23.5. Surgical Technique 338
23.6. Postoperative Management 343
23.7. Results 343
23.8. Conclusion 346
Mechanics and Healing of Rotator Cuff Injury 349
24.1. Biology and Biochemistry of Healthy Tendon 349
24.2. Mechanical Properties of the Supraspinatus Tendon 351
24.3. Types of Rotator Cuff Injury 351
24.4. Mechanisms of Healing 358
24.5. Future Directions 361
Postoperative Rehabilitation Following Arthroscopic Rotator Cuff Repair 365
25.1. Principles of Rehabililtation 365
25.2. Suggested Postoperative Protocols 369
25.3. Conclusions 378
How to Avoid and Manage Complications in Arthroscopic Rotator Cuff Repair 380
26.1. Nonspecific Surgical Complications 381
26.2. Specific Shoulder Arthroscopy Complications 382
26.3. Complications 384
Index 391