“Double-Row Rip-Stop” Technique for Arthroscopic Rotator Cuff Repair

Abstract

Rotator cuff repair depends on both the fixation strength of the chosen repair construct and the local healing response of the repaired tissue. Among a growing discussion surrounding the superiority of one surgical technique over another, the surgeon's ability to complete a rotator cuff repair with technical acuity in a timely manner remains paramount. Double-row repairs as well as rip-stop configurations have been proposed to limit failures found after arthroscopic rotator cuff repairs. Implementation of both techniques during arthroscopic shoulder surgery may represent a technical challenge for the average orthopaedist. The purpose of this article is to give simple instructions for reproduction of an arthroscopic double-row rip-stop repair for rotator cuff fixation.

Biomechanical evaluation of a novel double rip-stop technique with medial row knots for rotator cuff repair

“…Previous studies have described various rip-stop techniques; 44 - 46 however, these were different from the DRS technique. This is because the DRS technique had not only one rip-stop on the articular surface but also one on the bursal side of IST for each medial anchor.…”

The Arthroscopic “Montgolfier Double-Row Knotless” Rotator Cuff Repair Technique

“…This article details a double-row suture anchor repair that may provide advantages to the surgeon over prior iterations with suture anchors (Table 2). 7, 8, 9 The suture bridge technique, for example, was developed to optimize coverage of the footprint by crossing sutures over the repaired rotator cuff 4, 7. This contrasts with the linear suture configuration of the Montgolfier double row, which remains parallel to the long axis of the rotator cuff tendon and its medial blood supply 12 .…”

“…The Sugaya repair technique for commonly encountered delaminated tears can easily be used in combination 11 . Furthermore, to enhance fixation of the rotator cable at the leading edge of the supraspinatus, a modified Mason-Allen suture technique can be used in conjunction with this technique, similarly to a rip-stop suture 8, 19…”

“…These constructs have a high ultimate load to failure and permit maximal contact with the footprint of the greater tuberosity 5, 6. Nonetheless, anchor placement and suture configuration are reported variably in the literature, and no single technique has been shown to be superior 7, 8, 9…”

The Chinese Knot Stitch Technique Using a Footprint Ultrasuture Anchor for Rotator Cuff Repair

“…1 The rotator cuff suture method, which includes single-row, double-row suture, and the suture bridge techniques, enhances fixation. Recently, it has included a variety of locking sutures, such as the double-locked stitch, 2 the simple cow hitch stitch, 3 the "parachute" technique, 4 the double-row rip-stop technique, 5 the shoelace technique, 6 and the double-layer lasso loop technique. 7 For rotator cuff tears with degeneration or poor tendon quality, some studies have shown that the application of various locking ring sutures can decrease failure rate and prevent the rotator cuff from being re-torn during suture.…”