A Modified Suture-Bridge Technique for a Marginal Dog-Ear Deformity Caused During Rotator Cuff Repair

The Influence of Rotator Cuff Tear Size and Repair Technique on Creation and Management of Dog Ear Deformities in a Transosseous Equivalent Rotator Cuff Repair Model

“…While our data show that larger tears were more likely to result in larger dog ears, it lacked the power to show this relationship to be statistically significant. Alternatively, Kim et al 11 reported on a technique of using the suture tails from the lateral row anchors to create an additional site of compression in the marginal dog ear deformity, the so-called modified suture bridge. Other authors have purported using additional anchors 11 or a triple-mattress repair with a single row of triple-loaded suture anchors 12,13 to manage these deformities.…”

“…Alternatively, Kim et al 11 reported on a technique of using the suture tails from the lateral row anchors to create an additional site of compression in the marginal dog ear deformity, the so-called modified suture bridge. Other authors have purported using additional anchors 11 or a triple-mattress repair with a single row of triple-loaded suture anchors 12,13 to manage these deformities. However, there is no literature to quantify the size of these dog ear deformities before and after these various repair techniques.…”

“…With this increased contact area at the greater tuberosity footprint, we would expect better healing, in part because of less fluid extravasation and thus less interference with healing. 1 While we were unable to determine a threshold tear size at which the surgeon should expect marginal dog ear deformities, with larger tears, the surgeon should be prepared to address these deformities with either the modified suture bridge 11 or peripheral FiberLink sutures, as described here.…”

“…4 Despite the inherent advantages of this technique, the transosseous-equivalent rotator cuff repair also possesses some frequently encountered shortcomings, notably redundancies in the rotator cuff tissue, which are commonly referred to as ''dog ear'' deformities. Various suture patterns [10][11][12][13] have been created to minimize the occurrence of these deformities or manage them once they are formed, as consequences may include inadequate footprint restoration and impaired healing of the cuff to the greater tuberosity. Commonly encountered in other surgical wounds as well, dog ear deformities are the result of an asymmetric puckering or accumulation of tissue, typically in the center or at the apices of an incision.…”

Treating Full-Thickness Cuff Tears in the Athlete: Advances in Arthroscopic Techniques

“…38 One could take advantage of the residual sutures from the distal-lateral row (after implant deployment) to tie down any redundant ends of the tendon. 39 Bursectomy extending over the intended distal-lateral row facilitates anchor placement and suture management.…”