Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Arthroscopic supraspinatus advancement for retracted rotator cuff tears: a technical note

  • Chris Hyunchul Jo (Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine) ;
  • Pei Wei Wang (Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine)
  • Received : 2022.07.01
  • Accepted : 2022.09.18
  • Published : 2022.12.01
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Abstract

Irreparable rotator cuffs with retracted torn ends remain a significant challenge for most shoulder surgeons. Since repairs are preferable to reconstruction or replacement whenever possible, studies for anatomical reductions with minimal tension and secure fixation are important. In this study, the authors introduce an arthroscopic supraspinatus advancement (ASSA) procedure for retracted rotator cuff tears that could not be adequately reduced to the original footprint. Using modified long, narrow, curved Cobb elevators, procedures can be performed through lateral portals without any additional skin incision. Following meticulous stepwise three-compartment elevation procedures based on the supraspinatus insertion anatomy, the supraspinatus muscle could be safely elevated from the fossa and sufficiently advanced laterally. The authors suggest that ASSA could be a useful procedure for management of challenging retracted rotator cuff tears by maximizing lateral excursions that could convert irreparable tears to reparable tears in select patients.

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References

  1. Park MC, ElAttrache NS, Tibone JE, Ahmad CS, Jun BJ, Lee TQ. Part I: footprint contact characteristics for a transosseous-equivalent rotator cuff repair technique compared with a double-row repair technique. J Shoulder Elbow Surg 2007;16:461-8.
  2. Apreleva M, Ozbaydar M, Fitzgibbons PG, Warner JJ. Rotator cuff tears: the effect of the reconstruction method on three-dimensional repair site area. Arthroscopy 2002;18:519-26.
  3. Vastamaki M, Lohman M, Borgmastars N. Rotator cuff integrity correlates with clinical and functional results at a minimum 16 years after open repair. Clin Orthop Relat Res 2013;471:554-61.
  4. Yokoya S, Nakamura Y, Harada Y, Ochi M, Adachi N. Outcomes of arthroscopic rotator cuff repair with muscle advancement for massive rotator cuff tears. J Shoulder Elbow Surg 2019;28:445-52.
  5. Debeyre J, Patie D, Elmelik E. Repair of ruptures of the rotator cuff of the shoulder. J Bone Joint Surg Br 1965;47:36-42.
  6. Kurokawa M, Hirasawa Y. Clinical study of modified Debeyre's operation for massive tear of rotator cuff. J Shoulder Elbow Surg 1995;4 Suppl 1:S69.
  7. Morihara T, Kida Y, Furukawa R, et al. Therapeutic outcomes of muscular advancement by an arthroscopic-assisted modified Debeyre-Patte procedure for irreparable large and massive rotator cuff tears. J Orthop Sci 2018;23:495-503.
  8. Gupta A, Ker AM, Maharaj JC, Veen EJ, Cutbush K. All-arthroscopic muscle slide and advancement technique to repair massive retracted posterosuperior rotator cuff tears. Arthrosc Tech 2021;10:e1439-46.
  9. Jo CH, Shin JS, Shin WH, Lee SY, Yoon KS, Shin S. Platelet-rich plasma for arthroscopic repair of medium to large rotator cuff tears: a randomized controlled trial. Am J Sports Med 2015;43:2102-10.
  10. Kim SY, Boynton EL, Ravichandiran K, Fung LY, Bleakney R, Agur AM. Three-dimensional study of the musculotendinous architecture of supraspinatus and its functional correlations. Clin Anat 2007;20:648-55.
  11. Jo CH, Shin JS, Park IW, Kim H, Lee SY. Multiple channeling improves the structural integrity of rotator cuff repair. Am J Sports Med 2013;41:2650-7.
  12. Ha'Eri GB, Wiley AM. "Supraspinatus slide" for rotator cuff repair. Int Orthop 1980;4:231-4.
  13. Warner JP, Krushell RJ, Masquelet A, Gerber C. Anatomy and relationships of the suprascapular nerve: anatomical constraints to mobilization of the supraspinatus and infraspinatus muscles in the management of massive rotator-cuff tears. J Bone Joint Surg Am 1992;74:36-45.
  14. Greiner A, Golser K, Wambacher M, Kralinger F, Sperner G. The course of the suprascapular nerve in the supraspinatus fossa and its vulnerability in muscle advancement. J Shoulder Elbow Surg 2003;12:256-9.