Four patients did not complete clinical evaluations and functional outcome scores at a minimum of 2 years' follow-up and were lost to follow-up. Seventeen patients with a minimum of 2 years' follow-up were included. Twenty-one consecutive patients underwent arthroscopic rotator cuff repair with an LSRS construct between January and December 2014. To prospectively review functional outcomes and healing rates of large and massive rotator cuff tears repaired with a load-sharing rip-stop (LSRS) technique. Double-row endoscopic gluteus medius repair with knotless suture anchors may be an alternative to open repair. When tears occur, debate exists over whether open or endoscopic repair procedures are optimal. Gluteus medius tendinopathy is an increasingly common recognized etiology of lateral hip pain. Further, endoscopic technique is able to replicate open, knotless gluteus medius repair technique in terms of gap formation in physiologic (i.e., subfailure) cyclic loading. This study shows that both open and endoscopic gluteus medius repairs are stronger than the muscle–bone interface in a cadaveric model and loaded biomechanically in tension between the ilium origin and femoral insertion. Ninety-two percent of specimens failed near the muscle origin on the ilium. Gap formation and strengths of the construct were compared for the 2 techniques.īiomechanical testing resulted in no significant differences in ultimate load ( P =. Specimens were then returned to 10 N and ramped to failure at 1 mm/s. Specimens were manually preloaded to 5 N, then cycled between 20-50 N for 150 cycles s. Gluteus medius tears were created in an open fashion and then repaired with either open or endoscopic techniques. Six pairs of fresh-frozen human cadavers were used in this study.
To compare the repair strength, gap formation, and mode of failure between endoscopic and open double-row gluteus medius repairs in a cadaveric model. Arthroscopic rotator cuff repairs have been limited to simple and horizontal mattress stitches.5, 6 These stitches have significantly lower failure strength than the modified Mason-Allen stitch, which is commonly used in open rotator cuff repairs.5, 7, 8 DiscussionĪrthroscopic rotator cuff repairs have become popular with lower morbidity and ease of visualization.1, 2, 3, 4 Concerns have been raised regarding arthroscopic rotator cuff repair on the security of tissue fixation. Suture anchors are placed over the decorticated greater tuberosity. After the leading edge of the tendon is advanced laterally, an optional horizontal loop can be placed at the remaining leading edge of the rotator cuff (Fig 3). These side-to-side repair sutures are tied. A penetrator is used from front-to-back to place sutures for side-to-side repair (Fig 2). After the tear configuration is identified, margin convergence is first performed to reduce strain and prevent tear propagation (Fig 1).
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