The “Pull-Over” Technique for All Arthroscopic Rotator Cuff Repair With Extracellular Matrix Augmentation

Narvani, A; Imam, Mohamed A.; Polyzois, Ioannis; Sarkhel, Tanaya; Gupta, Rohit; Levy, Ofer; Consigliere, Paolo

doi:10.1016/j.eats.2016.11.007

Cited by 11 publications

(15 citation statements)

References 9 publications

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“…2 Moreover, enhanced arthroscopic instrumentation has simplified the arthroscopic technique for RCR with patch augmentation. 8 …”

Section: Discussionmentioning

confidence: 99%

“…Following SCR with LHB, the supraspinatus tendon is repaired using patch augmentation via the “pull-over” technique, as previously described. 8 This forms “layer 2” and “layer 3.”…”

Section: Surgical Technique (With Video Illustration)mentioning

confidence: 99%

“…The “pull-over” technique also involves passing a free suture (#2 FiberWire) through the medial aspect of the tendon and bringing this out through the Neviaser port. 8 This free suture is used to help “pull over” the augment into the subacromial bursa and secure it medially.

Fig 4 Standard medial row repair of the tendon tear using either 1 or 2 medial row anchors.…”

Section: Surgical Technique (With Video Illustration)mentioning

confidence: 99%

“…As has previously been described in depth, 8 the patch (Arthrex Dx Reinforcement Matrix; Arthrex) is then prepared outside the body by making 2 holes in the augment, through which the anchor suture limbs are passed, and a third hole more medially (approximately 5 mm from the medial edge of the patch and in between the other 2 holes) ( Fig 5 ). In addition, the corners of the rectangular patch are cut to leave an octagon ( Fig 5 ).…”

Section: Surgical Technique (With Video Illustration)mentioning

confidence: 99%

“…One limb of the free FiberWire is passed through the medial hole of the patch using a polydioxanone suture as a shuttle, while the anchor is passed through the 2 anterior and posterior holes (more lateral) of the patch as previously described in the “pull-over” technique ( Fig 5 ). 8 …”

Section: Surgical Technique (With Video Illustration)mentioning

confidence: 99%

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Hamburger Technique: Augmented Rotator Cuff Repair With Biological Superior Capsular Reconstruction

Memon

Dimock

Cobb

et al. 2020

Arthroscopy Techniques

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Despite profound advancements in arthroscopic rotator cuff repair (RCR) techniques, radiologic failure rates may be in excess of 60% with repairs of large and massive tears in the elderly population. One of the strategies to improve these healing rates has been "patch" augmentation of the cuff repair. At the same time, superior capsular reconstruction (SCR) has gained significant popularity as an option for irreparable rotator cuff (RC) tears. Some have also advocated performing SCR in addition to arthroscopic RCR to reinforce the repair and improve healing rates. Techniques involving the use of fascia lata, ECM patches, and long head of the biceps (LHB) for SCR to reinforce the cuff repair have all been elegantly described. In this article, we propose a technique that enables a combination of the aforementioned procedures and involves performing RCR with patch augmentation, as well as SCR using LHB. In doing so, the repaired RC is bordered by the patch over its bursal surface and the LHB on the articular surface (functioning as the superior capsule), thus giving us the name "Hamburger technique" (a 3-layered construct).

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“…2 Moreover, enhanced arthroscopic instrumentation has simplified the arthroscopic technique for RCR with patch augmentation. 8 …”

Section: Discussionmentioning

confidence: 99%

Section: Surgical Technique (With Video Illustration)mentioning

confidence: 99%

Fig 4 Standard medial row repair of the tendon tear using either 1 or 2 medial row anchors.…”

Section: Surgical Technique (With Video Illustration)mentioning

confidence: 99%

Section: Surgical Technique (With Video Illustration)mentioning

confidence: 99%

Section: Surgical Technique (With Video Illustration)mentioning

confidence: 99%

See 3 more Smart Citations

Hamburger Technique: Augmented Rotator Cuff Repair With Biological Superior Capsular Reconstruction

Memon

Dimock

Cobb

et al. 2020

Arthroscopy Techniques

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Graft use in the treatment of large and massive rotator cuff tears: an overview of techniques and modes of failure with MRI correlation

et al. 2018

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Despite technical advances, repair of large or massive rotator cuff tears continues to demonstrate a relatively high rate of failure. Rotator cuff repair or superior capsular reconstruction (SCR) using a variety of commercially available grafts provides a promising option in patients with tears that may be at high risk for failure or otherwise considered irreparable. There are three major graft constructs that exist when utilizing graft in rotator cuff repair or reconstruction: augmentation at the rotator cuff footprint, bridging, and SCR. Each construct has a unique appearance when evaluated using postoperative magnetic resonance imaging (MRI), and each construct has unique sites that are predisposed to failure. Understanding the basic principles of these constructs can help the radiologist better evaluate the postoperative MRI appearance of these increasingly utilized procedures.

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Superior capsular reconstruction of the shoulder: the ABC (Arthroscopic Biceps Chillemi) technique

Chillemi

Mantovani²,

Gigante

2018

Eur J Orthop Surg Traumatol

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Superior capsular reconstruction (SCR) demonstrated its efficacy as a treatment option available in patients affected with irreparable posterosuperior rotator cuff tears without any signs of arthritis. Originally, the fascia lata autograft was fixed medially to the glenoid (with two or more anchors) and laterally to the greater tuberosity (with a compression double-row technique using four anchors or three transosseous tunnels). Additionally, side-to-side sutures were used to anteriorly and posteriorly connect the graft to the native residual rotator cuff tissue. However, the fascia lata as an autograft has a disadvantage related to the donor-site morbidity. To solve this aspect, allografts were employed with initial promising results. Nowadays, SCR is to be considered a technically demanding and expensive procedure, because of the cost of the allograft plus that of all the anchors employed to fix it. The Arthroscopic Biceps Chillemi's technique addresses these concerns in performing SCR and presents numerous advantages being a safe, easier, time and cost-saving way compared to the other published techniques. This technique has only one conditio sine qua non: the presence of the long head of the biceps tendon (LHB), used as an autograft. This condition may be interpreted as a disadvantage of this procedure in the presence of some anatomic variations of the intra-articular portion of the LHB and the very rare absence of the tendon or in case of partial or complete rupture of the LHB tendon associated with a rotator cuff tear.

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The “Pull-Over” Technique for All Arthroscopic Rotator Cuff Repair With Extracellular Matrix Augmentation

Cited by 11 publications

References 9 publications

Hamburger Technique: Augmented Rotator Cuff Repair With Biological Superior Capsular Reconstruction

Hamburger Technique: Augmented Rotator Cuff Repair With Biological Superior Capsular Reconstruction

Graft use in the treatment of large and massive rotator cuff tears: an overview of techniques and modes of failure with MRI correlation

Superior capsular reconstruction of the shoulder: the ABC (Arthroscopic Biceps Chillemi) technique

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