Abstract
Cysts of the greater tuberosity can be a normal finding independent of age and concurrent
rotator cuff tear. The presence of a large greater tuberosity cyst can present a challenge
at the time of rotator cuff repair. We present a 1-step arthroscopic technique to
address these defects at the time of rotator cuff repair using a synthetic graft (OsteoBiologics,
San Antonio, TX) originally designed to address osteoarticular defects. With the viewing
portal established laterally, a portal allowing perpendicular access to the cyst is
established. The cyst is thoroughly debrided, and a drill sleeve is then introduced
perpendicular to the surrounding bone, serving as a guide for the matching drill to
create a circular socket. A correspondingly sized TruFit BGS cylindrical implant (OsteoBiologics)
is then implanted by use of the included instrumentation. The scaffold is placed flush
with the surrounding bone. Because our arthroscopic rotator cuff protocol uses a tension-band
technique with placement of suture anchors distal and lateral to the rotator cuff
footprint, we are subsequently able to proceed with routine rotator cuff repair.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Clinical presentation of complete tears of the rotator cuff.J Bone Joint Surg Am. 1989; 71: 499-505
- Acromial angle on radiographs of the shoulder: Correlation with the impingement syndrome and rotator cuff tears.AJR Am J Roentgenol. 1995; 165: 609-613
- Impingement lesions.Clin Orthop Relat Res. 1983; : 70-77
- Roentgenographic findings in massive rotator cuff tears.Clin Orthop Relat Res. 1990; : 92-96
- Radiographic findings associated with symptomatic rotator cuff tears.J Shoulder Elbow Surg. 2003; 12: 122-127
- Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss.J Orthop Res. 2005; 23: 1441-1447
- Humeral head cysts and rotator cuff tears: An MR arthrographic study.Skeletal Radiol. 2006; 35: 909-914
- Trabecular microstructure and surface changes in the greater tuberosity in rotator cuff tears.Skeletal Radiol. 2002; 31: 522-528
- Pullout strength of suture anchors used in rotator cuff repair.J Bone Joint Surg Am. 2003; 85: 2190-2198
- Iliac crest bone graft harvest donor site morbidity.Spine. 1995; 20: 1055-1060
- Donor site morbidity in the iliac crest bone graft.Aust N Z J Surg. 1999; 69: 726-728
- Sterilization, toxicity, biocompatibility and clinical applications of polylactic acid/polyglycolic acid copolymers.Biomaterials. 1996; 17: 93-102
- Mosaicplasty for the treatment of articular defects of the knee and ankle.Clin Orthop Relat Res. 2001; : S328-S336
- Arthroscopic repair of rotator cuff tears associated with large bone cysts of the proximal humerus: Compaction bone grafting technique.Arthroscopy. 2005; 21 (Available online at www.arthroscopyjournal.org.): 1149.e1-1149.e5
- Indications for allografts.Orthop Clin North Am. 2005; 36: 459-467
- Hospital-based allogenic bone bank—10-year experience.J Hosp Infect. 2005; 59: 41-45
Article Info
Publication History
Published online: March 06, 2007
Footnotes
The authors report no conflict of interest.
Cite this article as: Agrawal V, Stinson M. Arthroscopic grafting of greater tuberosity cyst and rotator cuff repair. Arthroscopy 2007;23:904.e1-904.e3 [doi:10.1016/j.arthro.2006.10.026].
Identification
Copyright
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
