Repairing rotator cuff tears utilizes a type of suture made of threaded materials as well as anchors. Advances have led to the development of a suture material made of multi-stranded, long chain ultra-high molecular weight polyethylene core with a braided jacket of polyester. The quantity and pattern in which these sutures are used vary depending on surgeon preference and the characteristic/size of the tear. Once these sutures are passed through the tendon, the tendon must then be re-attached to its original location on the bone. This is done with suture anchors and can be made of metal or a biodegradable material.
Rotator Cuff Repair
Historically, repair of the rotator cuff was done through a large open incision in the shoulder to visualize the torn tendon, which was then repaired and re-attached to the bone. Overtime, advances in surgical technique allowed surgeons to repair the tendon through a much smaller incision, called the mini-open repair. Further advances have led to the ability to repair the rotator cuff arthroscopically with a small camera and specialized instruments placed into the shoulder through 3 or 4 small incisions. Today, rotator cuff repairs are performed either through the mini-open approach or most commonly, arthroscopically. The surgeon first removes any bones spurs and inflamed tissue, which creates space for the repaired rotator cuff tendon. Then, anchors with suture are used to reattach it back to the bone.
Rotator Cuff Tear
The rotator cuff consists of four muscles around the shoulder that help raise and rotate the arm. The most commonly injured of these muscles is the supraspinatus and occurs in the tendon where the muscle attaches to the humerus upper arm bone (humerus). Rotator cuff tears are generally caused by falls, overuse, or normal aging. Often small tears will lead to larger tears in the future simply due to neglect of the initial tear. Patients with rotator cuff tears will usually have pain on the outside of the shoulder, up the neck or down the arm. Symptoms include the inability to raise one arm above shoulder level. Smaller, or partial thickness tears, can many times be treated without surgery. However, tears that are larger, or full-thickness, have a much higher chance of not healing and may require surgical intervention.
The Arthrex SpeedBridge™ Rotator Cuff Repair system is an example of the latest advances in surgical technique that allows for great strength and reliability of rotator cuff repairs. This system includes bioabsorbable BioComposite SwiveLock suture anchors combined with FiberTape, a type of threaded suture material. The benefit of this system is that it can be done knotless, so that the strength and tension of the repair is more accurate and consistent by not relying on a provider’s ability to tie knots with the right tension.
Additionally, the pattern in which the FiberTrape is attached is called the double-row technique, which allows for a broad area of attachment of the tendon back to the bone to help with healing. Lastly, the bioabsorbable BioCompose suture anchors facilitate bony ingrowth resulting in improved insertion and pullout strength.