Hybrid Repair of Large Crescent Rotator Cuff Tears Using a Modified SpeedBridge and Double-Pulley Technique

Abstract

An ideal rotator cuff repair maximizes the tendon-bone interface and has adequate biomechanical strength that can withstand a high level of demand. Arthroscopic transosseous-equivalent rotator cuff repairs have become popular and have been shown to be superior to many other methods of fixation. We present an alternative method of repair for large crescent rotator cuff tears that combines 2 well-known methods of fixation: modified SpeedBridge (Arthrex, Naples, FL) and double-pulley techniques. These 2 repair constructs were combined to provide the greatest amount of compression across the footprint while also providing rigid fixation. Ultimately, this can provide an optimal environment for healing in otherwise significant injuries.

Venous thromboembolism after arthroscopic rotator cuff repair in a patient with a negative presurgical SARS-CoV-2 test who developed symptomatic COVID-19 three days after surgery

“…2). 2 Based on her preoperative clinical and imaging findings, a subacromial decompression and an arthroscopic suprapectoral biceps tenodesis was also performed as described. 4 The operative time was recorded as 65 minutes for this case.…”

Linked Double-Row Equivalent Arthroscopic Rotator Cuff Repair Leads to Significantly Improved Patient Outcomes

“…The knotless linkage allows equal load sharing across the repair by using the anchors as pulleys to potentiate the strength of repair. 3 , 9 , 10 , 16 , 20 , 24 , 42 …”

The Arthroscopic “Montgolfier Double-Row Knotless” Rotator Cuff Repair Technique

“…This article details a double-row suture anchor repair that may provide advantages to the surgeon over prior iterations with suture anchors (Table 2). 7, 8, 9 The suture bridge technique, for example, was developed to optimize coverage of the footprint by crossing sutures over the repaired rotator cuff 4, 7. This contrasts with the linear suture configuration of the Montgolfier double row, which remains parallel to the long axis of the rotator cuff tendon and its medial blood supply 12 .…”

“…These constructs have a high ultimate load to failure and permit maximal contact with the footprint of the greater tuberosity 5, 6. Nonetheless, anchor placement and suture configuration are reported variably in the literature, and no single technique has been shown to be superior 7, 8, 9…”