Name: Posterior-Approach CuffMend™ Augmented Rotator Cuff Repair With FiberStitch™ RC
Uploaded: 2023-12-22T00:00:00Z
Channel: Arthrex
Description: Christopher Donaldson, MD (Tampa, FL), demonstrates the surgical technique for a posterior-approach CuffMend™ augmented rotator cuff repair using FiberStitch™ RC as medial graft fixation. View the graft preparation technique video .

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Christopher Donaldson, MD (Tampa, FL), demonstrates the surgical technique for a posterior-approach&nbsp;CuffMend™ augmented rotator cuff repair using&nbsp;FiberStitch™ RC as medial graft fixation. View the&nbsp;<a href="https://www.arthrex.com/resources/VID1-006070-en-US/graft-preparation-for-cuffmend-posterior-approach?referringteam=shoulder">graft preparation&nbsp;technique video</a>.

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VID1-004077-en-US | B | Posterior-Approach CuffMend™ Augmented Rotator Cuff Repair With FiberStitch™ RC

Christopher T. Donaldson

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

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Posterior-Approach CuffMend™ Augmented Rotator Cuff Repair With FiberStitch™ RC

My name is Doctor Christopher Donaldson from Tampa, Florida. I'm here to demonstrate today the CuffMend technique with the posterior approach. Utilizing the insertion device with the 2.0mm ArthroFLEX graph will be fixating the graph medially with the FiberStitch RC device and the gray handle, and then laterally fixing the graph with the self-punching PushLock anchors. This repair has been completed with the FiberTak SpeedBridge, three medial row anchors and two lateral row anchors. We're utilizing the posterior portal for passage of this CuffMend the lateral working portal anterior to where the scope is positioned. And then we are placing a NanoScope for reference so that we can address and visualize the biceps in a situation where the biceps would remain after a rotator cuff repair, and where we're augmenting the rotator cuff. So to find the working window, we've placed a spinal needle just posterior to the biceps, which we can see from our NanoScope picture for completeness. And that's going to act as a guide point for us to place our graph from posteriorly and then begin to fix with our FiberStitch arc on the medial side. Once we gain the trajectory with our spinal needle, we're on the subacromial side. We're going to introduce the CuffMend graft from posteriorly the insertion device. This will then be delivered to the appropriate position. We can see our spinal needle, which acts as a guide for us that we know is posterior to that biceps tendon on the intra-articular side. So as we place the CuffMend into position, we're utilizing several different guide points. This is the spinal needle locating the posterior aspect of the biceps, which we located previously. By looking in the joint, the spinal needle was on the posterior aspect of the biceps in relation. We're now in the subacromial space. This is the anterior on this side. This is the medial side of the CuffMend. What we're going to do is to locate our trajectory in the intra-articular space. We want to make sure we're not too far in the lateral side where we can contact head. We can probe down. Once we feel the head is there, we can move more medial again not too far medial so as to get into the space where we might contact the glenoid. This would be the intra-articular space trajectory. Place the spinal needle nice and easy. Fluid motion down into the intra-articular space. No contact. Which assures us that we're at the appropriate trajectory. Next, we're going to remove that spinal needle. We're going to take our FiberStitch RC implant. We place it into the same trajectory we had previously. This is then deployed down through the CuffMend into the Intra-articular space. We then wheel this handle back until we hear an audible click wheel forward again to an audible click, and then we're able to reposition our implant with appropriate space so as to gain fixation of our CuffMend for augmentation. This is then delivered again down into the Intra-articular space, again with our depth. Stop helping us wheel this black handle back until you hear an audible click, and then forward again, simultaneously hearing an audible click. This is then removed. We then are able to bring our tension down to the appropriate tension on top of the CuffMend on the subacromial space, pulling then the single limb to deliver the appropriate tension of the implant as it sits on the subacromial side. Once the appropriate tension is delivered, we'll then utilize our cutting device. We're then going to load our tensioner cutter. And this is going to allow us to gain trajectory back into the subacromial space where we're going to again check our tension and then deliver this plunger down so as to cut the suture. We're going to place the second FiberStitch RC posteriorly and then repeat tensioning and cutting as previously discussed for the first time. We're now in the lateral row placing our fixation with the Self-punching PushLock. We leave a little bit of slack in that so that we don't over tension this lateral side, so that as the PushLock is seated, that tension is taken up. For perspective, that's the anterolateral PushLock. We're against the bone so that we can clearly see that we're in a safe position to insert the anchor, not skiving off in one direction or the other. A little bit of laxity in the sutures so that they're not over tension when we seat this PushLock down. Okay. We're then going to use this to cut flush against the suture that's been seated. Once we put in our final lateral row anchor, you can see the graph is nicely fixed over the rotator cuff repair.

CuffMend™-Technik zur Augmentation der Rotatorenmanschette

Posterior-Approach CuffMend™ Augmented Rotator Cuff Repair With FiberStitch™ RC

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