Knotless Suture Bridge Technique in High-Grade Bursal-Sided Rotator Cuff Tears. Is This The Way Forward? Bancha Chernchujit, M.D., Mohd Azrin Shahul.

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Knotless Suture Bridge Technique in High-Grade Bursal-Sided Rotator Cuff Tears. Is This The Way Forward? Bancha Chernchujit, M.D., Mohd Azrin Shahul Hamid, M.B.B.S., M.S.(ORTHO), Sittan Aimprasittichai, M.D. Arthroscopy Techniques Volume 6, Issue 6, Pages e2259-e2263 (December 2017) DOI: 10.1016/j.eats.2017.08.016 Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 1 Bird's eye view of the right shoulder with a 30° arthroscope from the lateral (L) portal. The anterosuperior (AS) portal is located just adjacent to the acromioclavicular joint. The spectrum device was introduced from the posterior portal (P). (PL, posterolateral.) Arthroscopy Techniques 2017 6, e2259-e2263DOI: (10.1016/j.eats.2017.08.016) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 2 Arthroscopic view of the right shoulder viewed from the posterior portal with a 30° arthroscope. The intact articular side rotator cuff footprint depicted by the red arrow. Arthroscopy Techniques 2017 6, e2259-e2263DOI: (10.1016/j.eats.2017.08.016) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 3 Arthroscopic view of the right shoulder viewed from the posterolateral portal using a 30° arthroscope showing a high-grade bursal-sided tear. The exposed footprint (black arrow) after decortication. Note that the tear (red star) did not extend to the articular side. Arthroscopy Techniques 2017 6, e2259-e2263DOI: (10.1016/j.eats.2017.08.016) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 4 Arthroscopic view of the right shoulder viewed from the posterolateral portal using a 30° arthroscope. The 2 free sutures (ULTRABRAID and ETHIBOND EXCEL) being relayed through the rotator cuff. Arthroscopy Techniques 2017 6, e2259-e2263DOI: (10.1016/j.eats.2017.08.016) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 5 Arthroscopic view of the right shoulder viewed from the posterolateral portal using a 30° arthroscope. The 6 limbs of the free sutures (red stars) being tensioned individually before the anchor (FOOTPRINT PK) being advanced into the lateral cortex. Arthroscopy Techniques 2017 6, e2259-e2263DOI: (10.1016/j.eats.2017.08.016) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 6 Arthroscopic view of the right shoulder with the patient in beach chair position, viewed from the posterolateral portal using a 30° arthroscope showing the bursal-sided tear after the repair. The sutures uniformly press down the whole tissue of the rotator cuff to the footprint (red arrow), distributing even tension. Arthroscopy Techniques 2017 6, e2259-e2263DOI: (10.1016/j.eats.2017.08.016) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 7 Arthroscopic view of the right shoulder viewed from the posterior portal using a 30° arthroscope showing the long head of biceps tendon being mobilized with a probe to ensure no incarceration of the sutures to the biceps tendon. The red arrow shows the suture that was relayed from the subacromion space. Arthroscopy Techniques 2017 6, e2259-e2263DOI: (10.1016/j.eats.2017.08.016) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions