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Knotless anatomic double-layer double-row rotator cuff repair: a novel technique re-establishing footprint and shape of full-thickness tears

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

The standard technique for restoring footprint after full-thickness tears of the rotator cuff includes double-row or transosseous-equivalent techniques. However, the anatomically typical bird’s beak shape and profile of tendon insertion may not be originally restored and biomechanics may be altered. In this report, the authors describe a technique that involves creating two intratendinous stitches at different levels of the torn tendon. The first passes through the bursal-side layer, the second stitch through the joint-side layer. Both stitches may be performed in mattress suture configuration. The anchorage is performed by knotless anchors in order to avoid knots lying within the insertion area. The footprint is restored first medially then laterally by the use of double-row principles. The joint-side suture is anchored within the medially placed anchor. The bursal-side suture is anchored by a laterally placed anchor. The anatomic insertion and restoration of the shape and profile may be enabled by the described double-layer suture technique. Using a double-layer double-row repair may potentially improve functional results of rotator cuff repair constructs.

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Authors and Affiliations

  1. Department of Trauma and Reconstructive Surgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany

    Pierre Hepp, Thomas Engel, Georg Osterhoff, Bastian Marquass & Christoph Josten

Authors
  1. Pierre Hepp
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  2. Thomas Engel
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  3. Georg Osterhoff
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  4. Bastian Marquass
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  5. Christoph Josten
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Correspondence to Pierre Hepp.

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Hepp, P., Engel, T., Osterhoff, G. et al. Knotless anatomic double-layer double-row rotator cuff repair: a novel technique re-establishing footprint and shape of full-thickness tears. Arch Orthop Trauma Surg 129, 1031–1036 (2009). https://doi.org/10.1007/s00402-008-0625-7

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  • DOI: https://doi.org/10.1007/s00402-008-0625-7

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