A Novel Arthroscopic Inside-Out Repair Technique for PASTA Lesions

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Presentation transcript:

A Novel Arthroscopic Inside-Out Repair Technique for PASTA Lesions Lindsey S. Caldwell, M.D., Anna R. Cooper, M.D., M.P.H., John C. Elfar, M.D. Arthroscopy Techniques Volume 3, Issue 5, Pages e565-e570 (October 2014) DOI: 10.1016/j.eats.2014.06.009 Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 1 Arthroscopic view of glenohumeral joint with probe pointed into partial articular-sided supraspinatus tendon tear. Arthroscopy Techniques 2014 3, e565-e570DOI: (10.1016/j.eats.2014.06.009) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 2 The PDS suture has been retrieved through the anterior portal after being passed from the first port-of-Wilmington portal. The spinal needle is establishing the second port-of-Wilmington portal. Arthroscopy Techniques 2014 3, e565-e570DOI: (10.1016/j.eats.2014.06.009) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 3 A suture has been shuttled through the first 2 port-of-Wilmington portals so that the loop is outside the anterior portal. The spinal needle is establishing the third port-of-Wilmington portal. Arthroscopy Techniques 2014 3, e565-e570DOI: (10.1016/j.eats.2014.06.009) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 4 Shuttle suture after being passed through third port-of-Wilmington portal and tied over loop of nonabsorbable suture outside anterior portal. Arthroscopy Techniques 2014 3, e565-e570DOI: (10.1016/j.eats.2014.06.009) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 5 View from inside joint after loop of nonabsorbable suture has been retrieved through third port-of-Wilmington portal. Arthroscopy Techniques 2014 3, e565-e570DOI: (10.1016/j.eats.2014.06.009) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 6 The sutures are identified in the subacromial space. Subacromial decompression is performed, with care taken not to disrupt the sutures. The free ends of the sutures and loop are retrieved through the lateral portal. Arthroscopy Techniques 2014 3, e565-e570DOI: (10.1016/j.eats.2014.06.009) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 7 The 2 single ends of the white tiger-striped sutures in the foreground, viewed from the subacromial space, have been looped twice through the loop of suture outside the lateral portal and have been seesawed down snug against the bursal side of the rotator cuff. The blue sutures in the background represent a separate stitch. The free ends of the white tiger-striped stitch remain outside the lateral portal and will be passed through a knotless anchor. Arthroscopy Techniques 2014 3, e565-e570DOI: (10.1016/j.eats.2014.06.009) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 8 Shoulder model showing location of anchor site (star). Arthroscopy Techniques 2014 3, e565-e570DOI: (10.1016/j.eats.2014.06.009) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 9 Placement of knotless anchor with free ends of suture through it. Arthroscopy Techniques 2014 3, e565-e570DOI: (10.1016/j.eats.2014.06.009) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 10 View from bursal side after placement of knotless anchor. Arthroscopy Techniques 2014 3, e565-e570DOI: (10.1016/j.eats.2014.06.009) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions