Tears of the Rotator Cuff Part 3: Suture Anchor Repair of the Rotator Cuff
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- เผยแพร่เมื่อ 19 ส.ค. 2023
- In this video we will take a closer look at some of the more basic techniques we use to repair a rotator cuff tear. Tears come in many different sizes and there are many variables that need to be taken into consideration when repairing a rotator cuff tear. The implants used for rotator cuff tears are called suture anchors. These can be made of different materials and contain integrated sutures (stitches) that are used to secure the torn tendon edges back into place while the tear heals. Many different patterns of repairs can be utilized and each has their role in surgery.
Great teaching. I was an endo nurse/tech and advanced to doing the higher risk patients in all settings of the hospital. Using wires and variois tools similar. I am impressed by your teaching and technique. It takes alot of patience and a good eye and steady hand. Always making sure tools and backup equipment were available in any situation.
Excellent description and illustration. Well done!
Cool video!!! I watched this and felt so much more comfortable going in to have my surgery.
Awesome!
Thank you Dr. Witty. It's so helpful to be able to visualize all of this. I see my surgeon in two days and will be reviewing my MRI with him. Now I'll be more knowledgeable.
I’m having rotator cuff repair December 11 and this was interesting to see how it’s done.
This was exceptional Dr Witty i and many others ..really appreciate you and your wonderful and informative information
Glad you found it helpful!
Thanks for being an orthopedic surgeon. It hurt just watching it.
Dr. Witty, that was very well done and interesting! I’m having partial torn RC surgery next month and this gives me a great perspective on how the tear will be repaired.
Thanks for reaching out. Good luck with your surgery!
Wow! Great video! Your videos are so informative and helpful!
Thanks so much for the feedback. Hopefully, I can continue to find time to add content!
Great video and explanation! All 3 videos were very helpful. Thank you!
Thanks for watching!
So interesting! Looks like I had the 3rd method done on my right shoulder. I’ve got 3 images I snapped of the computer screen while my Dr was going over what was done. I envisioned the screw to be about 3/8” in diameter. Interesting to see how tiny they are. I wish I could say my surgery was 100% successful, but it wasn’t. Better than before though.
Brilliant demonstration, thank you very much.
Thanks Doc!
Thank you so much! Very informative.
Thanks so much for a very informative video.
I am glad you found it helpful.
Thanks, you have made sense of my pictures after my surgery. Do you have any on fatty infiltrate of a chronic tear?
I don't have a video on that at the moment. It would be a good topic to cover at some point. Any other suggestions for topics?
Great video!
Is there any risk that the anchors come out? I'm a volleyball player and I just had the rotator cuff repaired (2 tears, 1 in suprasupinatus, 1 in infrasupinatus). There are 2 PEEK anchors.
Thanks for the question.
The chance of an anchor pulling out is very low. I have only seen it happen after a patient actually fell onto the shoulder right after surgery!
Does putting a suture through the tendon weaken the tendon? Very good video. I had a full tear repair on my left shoulder in October 2022, right one is next.
Thanks for the question.
The sutures are pretty small and don't really affect the tendon. I suppose you could put a LOT of sutures through the tendon and that could cause a problem. During surgery we use enough to hold the tendon securely without overdoing it.
The bigger issue can actually be room on the bone for the actual anchors to "anchor". There is only so much real estate and you have to be strategic when deciding the best location for fixation and counter-acting the forces across the tendon. Anchors sizes can vary depending on the needs of the surgery, quality of the bone etc.
How do you keep the bone from cracking when tapping in the awl?
Good question.
You have to be careful and have a steady hand!
After the surgery will the impact like suture anchor and fibers be visible through an Xray or CT scan?
Just had mri ,going to surgeon soon.2 complete tears one of the sup and one of in .. .muscles..(sorry can't pronounce the actual names) they retracted back to rhe Hemral
Thanks for the video. I have a supraspinatus tear, and I’m considering surgery or not. My question : does the tendon,when repositioned by the sutures, actually reattach to the bone with time ? Or it’s just the sutures the will hold it on place ? I’m 52. Thank you
Thanks for your question.
Good question. The repair sutures hold the tendon in place until the tissue heals back to bone. This takes time which is why we use a sling after surgery and have restrictions regarding activity. After enough time has passed, the strength of the tendon where it has healed to bone will tolerate the load through the shoulder.
@@JeffreyWittyMD
I have same tear . Not sure how many anchors he is going to use. I'm afraid to ask .
Will the degree of tear get worse over time if surgery is not done ?
This is an important question.
The answer is that "it depends". Smaller / incomplete tears may not get bigger in size. However, larger tears can indeed get bigger with time. If the tears get bigger the tendon may retract further from the attachment site on the humerus. The muscle attached to the tendon can also atrophy over time as well. A detailed review of your MRI with an ortho surgeon can help you understand your particular injury.
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Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.
All patients have been consented for use of any imaging, video, or other media.
Why not drill a pilot hole?
Good question,
We use the awl because it compacts the bone (instead of removing bone) around the pilot hole which allows for better purchase of the anchor into the bone.
@@JeffreyWittyMD OK. Makes sense. The bone walls are denser than normal. Thanks
How long is recovery time after surgery ?
Thanks for the question.
I usually quote about 6 months of time before people are fully released for unrestricted activity. Keep in mind that each injury is unique and every patient is different and they may take different amounts of time to get back to their desired activity. In general, I use a sling for 6 weeks after surgery, strengthening at 12 weeks after surgery and then about 6 months I am looking to see if people are ready to be fully released. Also, different patients have different activity demands (think an athlete vs sedentary person). This will potentially add the time it takes to develop the strength and skill that particular sport/activity/work requires.
___________________________________________________________________________
Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.
@@JeffreyWittyMD would you recommend this surgery for a 76 year old man ?
I just had rotator cuff surgery six days ago . Now I know why it hurt so much post op. There is a lot going on. Thank for the video, it really helps.🦴😢
The first week after shoulder surgery can definitely be tough! Things should keep getting better each week. Just take it a day at a time. Hang in there and good luck!