Abstract
Surgical repair of the rotator cuff must have good resistance and should restore the
tendon footprint. To attain this goal, a stitch with a strong biomechanical profile
that avoids tissue strangulation should be used. We describe an arthroscopic suture
technique undertaken to repair rotator cuff tears with a single triple-loaded suture
anchor. The technique consists of a combination of a horizontal mattress and 2 vertical
simple sutures that are positioned medial to the mattress suture. The suture anchor
used is the 5-mm self-tapping ThRevo (Linvatec). This anchor is loaded with 3 sutures:
2 No. 2 nonabsorbable braided polyester sutures of different colors and a central
high-strength No. 2 polyethylene suture. The shape of the anchor eyelet permits all
3 sutures to glide freely. A modified Mason-Allen technique (Alex stitch) that combines
a horizontal side-to-side suture and 2 simples sutures as vertical loops is used.
With use of the Spectrum suture passing device and shuttle relay system (Linvatec),
both limbs of the centrally located polyethylene suture are passed through the cuff
from bottom to top, approximately 1 cm from the tendon edge. This suture is not immediately
tied. Next, with use of the same system, the other 2 sutures are placed medially and
over the previous horizontal suture. Simple sutures are placed at an approximately
30° angle from the center of the anchor; 1 is placed anterior and the other posterior.
The sutures are tied through the lateral portal. The mattress horizontal central stitch
is always tied first, followed by the 2 vertical sutures. The horizontal mattress
suture serves as a “rip stop stitch” and theoretically reduces the possibility of
cutting out of the simple sutures.
Key Words
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Article info
Footnotes
Cite this article as: Castagna A, Garofalo R, Conti M, Borroni M, Snyder SJ. Arthroscopic rotator cuff repair using a triple-loaded suture anchor and a modified Mason-Allen technique (Alex Stitch). Arthroscopy 2007;23:440.e1-440.e4 [doi:10.1016/j.arthro.2006.07.046].
The authors report no conflict of interest.
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Copyright
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
