Arthroscopic Repair of Rare Transtendinous Rotator Cuff Tear: Utilizing Established Portals and a Posterior Superior Accessory Portal Shane Anderson,

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Presentation transcript:

Arthroscopic Repair of Rare Transtendinous Rotator Cuff Tear: Utilizing Established Portals and a Posterior Superior Accessory Portal Shane Anderson, B.S., Scott Trenhaile, M.D. Arthroscopy Techniques Volume 8, Issue 4, Pages e419-e422 (April 2019) DOI: 10.1016/j.eats.2018.11.021 Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 1 Right shoulder arthroscopic view of the subacromial space from the lateral portal showing a complete transtendinous rotator cuff tear. Note significant lateral tendon attached to the greater tuberosity. (MT, medial tendon; LT, lateral tendon.) Arthroscopy Techniques 2019 8, e419-e422DOI: (10.1016/j.eats.2018.11.021) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 2 Right shoulder image showing locations of the portals used in the procedure. The posterior superior accessory portal is used to increase visualization and avoid debridement and damage to intact rotator cuff tendon posteriorly and laterally. (PSAP, posterior superior accessory portal; Neviaser, Neviaser portal.) Arthroscopy Techniques 2019 8, e419-e422DOI: (10.1016/j.eats.2018.11.021) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 3 Right shoulder arthroscopic view of the subacromial space from the posterior superior accessory portal showing a complete transtendinous rotator cuff tear. Note significant lateral tendon attached to the greater tuberosity. (MT, medial tendon, LT, lateral tendon.) Arthroscopy Techniques 2019 8, e419-e422DOI: (10.1016/j.eats.2018.11.021) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 4 Right shoulder arthroscopic view of the subacromial space from the posterior superior accessory portal. This view shows the location of the 5.5 Healicoil Regenesorb anchor (Smith & Nephew) being placed through the Neviaser portal into the medial portion of the greater tuberosity. These portals allow for a perpendicular angle into the greater tuberosity under direct visualization. Arthroscopy Techniques 2019 8, e419-e422DOI: (10.1016/j.eats.2018.11.021) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 5 Right shoulder arthroscopic view of the subacromial space from the posterior superior accessory portal. A retrograde suture passer is passed through the lateral portal to pull suture through the lateral portion of the tendon. (LT, lateral tendon.) Arthroscopy Techniques 2019 8, e419-e422DOI: (10.1016/j.eats.2018.11.021) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 6 Right shoulder arthroscopic view of the subacromial space from the lateral portal. A retrograde suture passer is passed through the Neviaser portal to pull suture through the medial portion of the tendon. (MT, medial tendon; LT, lateral tendon.) Arthroscopy Techniques 2019 8, e419-e422DOI: (10.1016/j.eats.2018.11.021) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 7 Right shoulder arthroscopic view of the subacromial space from the lateral portal showing a repaired transtendinous rotator cuff tear. The sutures were tied in a side-to-side fashion. A fourth suture was passed to reinforce the repair. (MT, medial tendon; LT, lateral tendon.) Arthroscopy Techniques 2019 8, e419-e422DOI: (10.1016/j.eats.2018.11.021) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions