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Arthroscopic Rotator Cuff Repair

Dr. Burkhart is Director of Orthopaedic Education, The San Antonio Orthopaedic Group, San Antonio, TX. Dr. Lo is Associate Professor, Department of Surgery, The University of Calgary, Calgary, AB, Canada.

Dr. Burkhart or the department with which he is affiliated has received royalties from Arthrex. Dr. Burkhart or the department with which he is affiliated serves as a consultant to or is an employee of Arthrex. Neither Dr. Lo nor the department with which he is affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.

Reprint requests: Dr. Burkhart, The San Antonio Orthopaedic Group, Suite 300, 400 Concord Plaza Drive, San Antonio, TX 78216.

Arthroscopic rotator cuff repair is being performed by an increasing number of orthopaedic surgeons. The principles, techniques, and instrumentation have evolved to the extent that all patterns and sizes of rotator cuff tear, including massive tears, can now be repaired arthroscopically. Achieving a biomechanically stable construct is critical to biologic healing. The ideal repair construct must optimize suture-to-bone fixation, suture-to-tendon fixation, abrasion resistance of suture, suture strength, knot security, loop security, and restoration of the anatomic rotator cuff footprint (the surface area of bone to which the cuff tendons attach). By achieving optimized repair constructs, experienced arthroscopic surgeons are reporting results equal to those of open rotator cuff repair. As surgeons’ arthroscopic skill levels increase through attendance at surgical skills courses and greater experience gained in the operating room, there will be an increasing trend toward arthroscopic repair of most rotator cuff pathology.

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