The Combined “Double-Pulley” Simple Knot Technique for Arthroscopic Transtendon Fixation of Partial Articular-Sided Tear of the Subscapularis Tendon

Abstract

Subscapularis tendon tears occur more frequently than previously suspected. Most subscapularis tendon tears are partial tears that have the potential to progress to complete tears. Repairs of partial tears of the tendon are performed to preserve normal shoulder function. This report describes a combined transtendon double-pulley and simple knot technique for repair of partial articular tears of the subscapularis tendon. This technique incorporates the advantages of transtendon repair, the double-pulley technique, and simple knot fixation.

SpeedBridge Knotless Double-Pulley Rotator Cuff Repair

“…The double-pulley repair method was developed to increase the contact area between the tendon and bone at the medial row of the repair, ultimately providing a wide area of tissue compression and equal pressure distribution between the suture strands overlying the tendon. 14 Combining a knotless double-pulley technique with the viable method of the knotless double-row, transosseous-equivalent repair achieves maximum footprint compression and improves the stability of the construct. A summary of the advantages and disadvantages of this technique can be found in Table 2 , and a summary of pearls can be found in Table 3 .…”

A new technique of arthroscopic subscapularis repair with 2-year clinical outcomes in an Asian population

“…Saremi 17 described a technique that takes into account ‘interstitial’ tears of the subscapularis tendon which had not been described in the more popularly used classification systems. Parnes et al 18 described a ‘combined double pulley simple knot’ technique (originally described by Arrigoni et al 19 ) for repairing the subscapularis that confers the advantage of avoiding excision of healthy tendon and maximizing tendon to bone contact surface area. Denard et al 20 described a double row fixation that uses a knotless technique that simplifies the repair for tears of the upper portion of the subscapularis.…”

Arthroscopic Intra‐Articular Repair of the Torn Subscapularis Tendon with Single Anterior Portal, Single Suture Anchor, and X‐Shaped Fixation Technique

“…Type 4/5 tears refer to complete ruptures of the entire tendon with or without anterior eccentricity of the humeral head. By now, a number of techniques aiming at arthroscopic subscapularis tendon repair have been described 11 , 15 , 16 , but most of them are technically challenging and time‐consuming. For example, multiple working portals are often required, and the suture management can be cumbersome.…”