Zusammenfassung
Für die erfolgreiche arthroskopische und offene Versorgung von Rotatorenmanschettenläsionen ist der Spagat zwischen einer ausreichend starken Primärfixation bis zum Einheilen der Sehne und der Schonung der durch Degeneration oder Verletzung zumeist schon vorbestehend kompromittierten Biologie der Sehnenheilung entscheidend. Bei den Bridging-Techniken wird hier eine Überlegenheit gegenüber den bisherigen Nahttechniken vermutet. Insbesondere von der Speedbridge-Technik wird eine suffiziente Heilung durch knotenlose und flächige Refixierung des gerissenen Sehnenmaterials erhofft. Diese kann, neben der ursprünglichen knotenlos gekreuzten Doppelreihenkonfiguration mit 4 Ankern, auch in einer knotenlosen V-, W(Kassiopeia)- oder sogar VW-Konfiguration eingesetzt werden. Gemeinsames Ziel ist hierbei eine maßgeschneiderte und das Heilungspotenzial der Sehne möglichst wenig beeinträchtigende Versorgung von Rotatorenmanschettendefekten bei zugleich hoher Anwenderfreundlichkeit.
Abstract
For successful arthroscopic or open repair of rotator cuff lesions the balance between sufficient fixation strength lasting long enough for tendon healing and no further damage to the degenerative or traumatically compromised biological healing mechanism is crucial. With bridging techniques an advantage is assumed compared to the established techniques. In particular with the Speedbridge technique sufficient tendon healing is expected due to knotless and laminar fixation of the ruptured tendons. Besides the originally described knotless and crossed double row configuration with four anchors this technique can also be applied in a knotless V, W (so-called Cassiopeia) or even VW configuration. The common objective is a tailored and tissue preserving repair of rotator cuff lesions with simultaneous high user friendliness.
Literatur
Anderl W, Heuberer PR, Laky B et al (2012) Superiority of bridging techniques with medial fixation on initial strength. Knee Surg Sports Traumatol Arthrosc [EPub ahead of Print, Feb 26]
Apreleva M, Ozbaydar M, Fitzgibbons PG et al (2002) Rotator cuff tears: the effect of the reconstruction method on three-dimensional repair site area. Arthroscopy 18:519–526
Baums MH, Buchhorn GH, Spahn G et al (2008) Biomechanical characteristics of single-row repair in comparison to double-row repair with consideration of the suture configuration and suture material. Knee Surg Sports Traumatol Arthrosc 16:1052–1060
Bishop J, Klepps S, Lo IK et al (2006) Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J Shoulder Elbow Surg 15:290–299
Burkhart SS, Adams CR, Schoolfield JD (2009) A biomechanical comparison of 2 techniques of footprint reconstruction for rotator cuff repair: the SwiveLock-FiberChain construct versus standard double-row repair. Arthroscopy 25:274–281
Christoforetti JJ, Krupp RJ, Singleton SB et al (2011) Arthroscopic suture bridge transosseus equivalent fixation of rotator cuff tendon preserves intratendinous blood flow at the time of initial fixation. J Shoulder Elbow Surg 21:523–530
Duquin TR, Buyea C, Bisson LJ (2010) Which method of rotator cuff repair leads to the highest rate of structural healing? A systematic review. Am J Sports Med 38:835–841
Galatz LM, Ball CM, Teefey SA et al (2004) The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am 86-A:219–224
Liem D, Lichtenberg S, Magosch P et al (2008) Arthroscopic rotator cuff repair in overhead-throwing athletes. Am J Sports Med 36:1317–1322
Longo UG, Berton A, Khan WS et al (2011) Histopathology of rotator cuff tears. Sports Med Arthrosc 19:227–236
Maffulli N, Longo UG, Berton A et al (2011) Biological factors in the pathogenesis of rotator cuff tears. Sports Med Arthrosc 19:194–201
Milano G, Grasso A, Zarelli D et al (2008) Comparison between single-row and double-row rotator cuff repair: a biomechanical study. Knee Surg Sports Traumatol Arthrosc 16:75–80
Nelson CO, Sileo MJ, Grossman MG et al (2008) Single-row modified mason-allen versus double-row arthroscopic rotator cuff repair: a biomechanical and surface area comparison. Arthroscopy 24:941–948
Pauly S, Fiebig D, Kieser B et al (2011) Biomechanical comparison of four double-row speed-bridging rotator cuff repair techniques with or without medial or lateral row enhancement. Knee Surg Sports Traumatol Arthrosc 19:2090–2097
Saridakis P, Jones G (2010) Outcomes of single-row and double-row arthroscopic rotator cuff repair: a systematic review. J Bone Joint Surg Am 92:732–742
Interessenskonflikt
Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehung hin: A.B. Imhoff ist als Consultant der Firma Arthrex, Inc. tätig.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Banke, I., Minzlaff, P., Pedersen, S. et al. Möglichkeiten der Speedbridge-Technik. Arthroskopie 25, 99–102 (2012). https://doi.org/10.1007/s00142-011-0666-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00142-011-0666-8
Schlüsselwörter
- Rotatorenmanschettenruptur
- Supraspinatusruptur
- Subskapularisruptur
- Schulterarthroskopie
- Speedbridge-Technik