CAR Modal

Human

Same Tab

Below is a collection of resources for you to learn more about the latest innovative products and techniques in shoulder sports medicine and arthroplasty. From shoulder repair to reconstruction, Arthrex has you covered.

Shoulder360

Shoulder

Arthrex.com

Rep Site

Rep App

Surgeon App

ArthrexTV

This animation provides an overview of the features and benefits of the Knotless 1.8 FiberTak® soft anchor for the treatment of shoulder instability.

Not Hidden

English  - en

video

A general overview including the relevant steps of an Arthrex surgical technique. These animations always include a voice-over explaining the process.

Eine allgemeine Übersicht, einschließlich der relevanten Schritte einer Arthrex Operationsanleitung. Diese Animationen enthalten immer Voice-Overs, die den Prozess erklären.

Operationstechnik-Animationen

Visão geral incluindo as etapas relevantes de uma técnica cirúrgica Arthrex. Essas animações sempre incluem uma narração explicando o processo.

Animações de técnicas cirúrgicas

Descripción general que incluye los pasos relevantes de una técnica quirúrgica de Arthrex. Estas animaciones siempre incluyen una voz en off que explica el proceso.

Animaciones de técnicas quirúrgicas

Surgical Technique Animations

Knotless 1.8 FiberTak® Soft Anchor for Shoulder Instability Repair

Patrick J. Denard, MD (Medford, OR), performs a live surgery using Knotless FiberTak® soft anchors for instability.

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

Eine Videoaufnahme einer Operationsanleitung an einem lebenden Patienten oder Patientin in einem Operationssaal oder eine Demonstration an einem Humanpräparat.

Operationstechnikvideos

Gravação em vídeo de uma técnica cirúrgica em um paciente em uma sala de cirurgia ou uma demonstração cadavérica.

Vídeos de técnicas cirúrgicas

Grabación en vídeo de una técnica quirúrgica de un paciente en un quirófano o una demostración cadavérica.

Videos de técnicas quirúrgicas

Surgical Technique Videos

Live Surgery: Instability Repair With Remplissage Using Knotless FiberTak® Soft Anchors

I'm Patrick Denard from Medford, Oregon. I'm going to demonstrate a bank card of Remplissage. Our defect is completely prepped. My next step is to place an accessory posterior cannula. I like to use a spinal needle first. This cannula is typically directly lateral to my posterior inferior cannula. Usually it's going to be 2 to 3cm. And I want to get an angle of approach that's going to aim toward the middle of the Hill-Sachs defect. So this is pretty good here because I'm right in the center of the defect. Next I'll take a switching stick and I'll go down to just above the posterior capsule to confirm that I'm at the right location. So we can see the switching stick. We are clearly just above the posterior tissue. I'll insert another seven millimeter threaded cannula. So the goal of the cannula is to go below the deltoid and just above the posterior soft tissue. And at this point I take the cannula and move it in a circular motion to clear out all the posterior soft tissue, which is the Bursa. And I can clearly see that I'm just above the posterior capsule and rotator cuff. Once we've established this space, it's really important that your assistant holds the cannula so it does not back out. I'm first going to insert my inferior anchor. You want to insert the inferior anchor first. Because once you insert the inferior anchor, it becomes difficult to see the superior anchor. So I use a 1.8mm knotless FiberTak anchor. I'll insert with a sharp guide to penetrate through the posterior tissue. I'll typically try to be right in line with the Hill-Sachs defect. I can just see the tip of the insertion guide here. That's going to provide a good angle of approach because I don't want to over or under tension the posterior capsule. Once I establish that location, sometimes I will move inferior so that I'm directed Where I have the most space just below the head. I'll remove the trocar of the guide, and I'll be just up against the cartilage of the humeral head. If I have a really large defect, sometimes I won't go all the way over to the medial edge of the defect. I typically find that A18 anchor works very well in this location. Now, prior to removing the guide, it's important to push the cannula back down to confirm that you have it just above the posterior capsule. And I'll remove the guide. Next I'm going to place my superior anchor. Now I will insert the guide first without the trocar in place. So both anchors are going to go through this same cannula. Once I get down to just above the tissue which I can see here, now I'll insert the trocar into place. And I think that's important so that I just do not catch the other sutures on my way down. So here we can see the spike just reaching the soft tissue. Once I go through, barely, I'll direct away so as to not damage the cartilage and just use a subtle twisting motion. Again, you can see my anchor placement is in line with the posterior capsule, so I'll tag both sets of sutures. I'll typically tag one shorter so that I can distinguish which anchor is which. So again we can see both sets of sutures are coming out the posterior cannula. And I'll set these to the side. At this point I'll move on to do my bankart repair. So I need to prep the labrum first. Typically I'll place anywhere from 3 to 4 anchors from inferior to superior. You can use a variety of suture configurations. With these anchors, you can use simple configurations or mattress configurations. I often use a hybrid approach where I will place a mattress suture configuration inferiorly. A simple configuration in the middle and then mattress again up top. So here is our completed bankart repair. You see, we nicely brought the labrum and the capsule up against the glenoid. The humeral head is already well centered. We have nice tension of the inferior glenohumeral ligaments. And now we're going to go complete our Remplissage. And I think this illustrates nicely how difficult it can be to do the Remplissage at the end. Because you can see already our space here is half that of which it was before. We're actually fortunate we can see in this case, because sometimes you get so much soft tissue swelling you can't see at all. So again, it's important to make that decision at the very beginning. So now we have both sets of suture limbs at our posterior cannula. The inferior anchor is here. The superior anchor is the one that I'm tagged by doubling up my assist. And I will take our repair sutures and pass these to each other. And then we will each convert so that the inferior repair limb will be going into the superior anchor, and the superior repair limb will be going into the inferior anchor. In order to create a double mattress knotless configuration. Okay, now both sets of sutures are converted and will simultaneously go back and forth to bring that soft tissue down to the Hill-Sachs defect. Okay, now our Hill-Sachs defect is extra articular and the capsule is right up against that bone bed. So there will be our final tightening. So here's our completed bankart and Remplissage. You see that this technique for the Remplissage in particular, let us complete this Remplissage in a very efficient manner, adding perhaps only five minutes to the case. The key steps being placement of the anchors first, followed by your bankart repair, and then going back and tensioning the Remplissage.

This animation demonstrates the features and benefits of the Knotless FiberTak® SpeedBridge™ implant system.

Animations demonstrating the features and benefits of a specific product.

Animationen, die die Funktionen und Vorteile eines bestimmten Produkts demonstrieren.

Produktdemonstrationen

Animações demonstrando os recursos e benefícios de um produto específico.

Vídeos de demonstração de produtos

Animaciones que demuestran las características y beneficios de un producto específico.

Videos de demostración de productos

Product Demonstrations

FiberTak® SpeedBridge™ Implant System Features and Benefits

Katherine Burns, MD (St. Louis, MO), presents a case using the FiberTak® SpeedBridge™ technique for rotator cuff repair, highlighting the tensionable knotless mechanism used to address a delaminated rotator cuff tear with Knotless 2.6 FiberTak RC anchors.

Surgeons presenting one or more clinical cases

Chirurg:innen präsentieren einen oder mehrere klinische Fälle

Videos von Fallpräsentationen

Cirurgiões que apresentam um ou mais casos clínicos.

Vídeos apresentações de casos

Cirujanos que presentan uno o más casos clínicos.

Video presentaciones de casos

Case Presentation Videos

FiberTak® SpeedBridge™ RCR With 2.6 FiberTak RC Anchors for Delaminated Rotator Cuff Tears

Speaker  Hi, I'm Doctor Catherine Burns from Saint Louis, Missouri. And I'm here today to talk to you about how I've incorporated the Knotless FiberTaks SpeedBridge into my rotator cuff repair technique. So we're all familiar with the SpeedBridge rotator cuff repair. This really is the gold standard and a workhorse for rotator cuff repair. We know that it's technically streamlined and very reproducible. It's expandable to a wide variety of sizes of tears and adaptable to different bone qualities. It provides secure fixation and footprint compression, and we know from the literature that we get excellent mid to long term results in terms of tendon healing, pain relief and functional outcomes. The Knotless SwiveLock adds to the flexibility of suture configurations without requiring additional anchors or knot tying. It's the same proven SwiveLock technology with excellent mid to long term results. And we know from the literature that if we add lateral augmentation, whether it's a luggage tag technique or using the knotless mechanism, this increases contact forces and pressure with minimal additional surgical effort. The Knotless FiberTak RC anchor is the latest anchor that you can utilize and incorporate into your SpeedBridge repair. This anchor creates a smaller hole on the footprint 2.6mm versus 4.75mm with comparable repair strength. It allows for multiple fixation points that increase the footprint compression forces, and this anchor is self-punching and can be placed with or without a guide, which allows the anchor to be placed in one step. Internal data suggests that the contact area may be increased by as much as 14% compared to hard body anchors. This anchor is loaded with tape. The tape is 1.7mm versus two millimetres, which allows three sutures to fit into a standard SwiveLock eyelet laterally. Speaker  The sutures are joined, as you would expect for a SpeedBridge repair. This patient is a 45 year old man who is a laborer, right hand dominant, with a BMI of about 35. He works in a warehouse and has about one year of symptoms on the left shoulder. He's had nonoperative treatment, including physical therapy, a home exercise program, and Tylenol. This patient declined a steroid injection and cannot take anti-inflammatories due to a history of gastric bypass. He had a successful rotator cuff repair on the opposite side three years ago, and feels like the symptoms are very similar on this shoulder. His exam findings are relatively benign, including good range of motion and reasonable strength, but he does have rotator cuff findings, including pain with Neer and Hawkins maneuver. These MRI images are representative Of his rotator cuff tear, and what you can see is a focal full thickness rotator cuff tear without retraction or significant atrophy that would be really amenable to a SpeedBridge repair. The findings at the time of surgery are what you might expect a U-shaped tear that appears reasonably mobile, with a tissue reducing over to the tuberosity. Here, you can appreciate the deeper tissues also mobilized over to the tuberosity, but on closer inspection on this angle, what you can see is that these medial fibers are actually not as mobile. They are retracted more medially and they only come to the medial footprint. And that's different than the more superior fibers that are mobilizing more to the lateral aspect of the tuberosity. So the way that I approach this is with the RC anchors performing a FiberTak SpeedBridge repair. Speaker  So I've placed anchors anteriorly and posteriorly. But the difference is that with these knotless mechanisms, I can use the knotless mechanism of these anchors to restore the medial tissue down to the medial footprint and basically have an anatomic reduction of that tissue down to the medial footprint. Here the anterior tissue is a little more delaminated, but reduces nicely and doesn't overly constrain the superior fibers. These anchors are placed just like I would place swivel locks. But because the FiberTaks are smaller, there's actually room for a third anchor. And with that third anchor, I can further reduce the tissue that's on the medial aspect of the footprint down to the bone. Once that's done, then the joint sutures can just be passed as you would pass for a standard SpeedBridge repair. So the tissues can be secured anteriorly centrally and posteriorly using the joint sutures. And then those sutures can be brought over to a SwiveLock just as you would for a standard SpeedBridge. The anterior cable and dog ear is visible here, and that's really readily stabilized with the knotless mechanism of the Knotless SwiveLock anchor. The second SwiveLock can be placed, and the remaining three sutures can be secured. And again here it doesn't look like I have a dog ear, but there is a dog ear of tissue, something not fully compressed, and that's very easily addressed with the knotless mechanism that's already there in the knotless SwiveLock. So you can see that by using the Knotless FiberTak repair, I'm able to restore the medial footprint, get good compression of the tissues, and restore the anterior and posterior aspect of the cable down to bone.

This animation demonstrates the features and benefits of the CuffMend™ rotator cuff augmentation system.

CuffMend™ Rotator Cuff Augmentation System Features and Benefits

Misty Suri, MD (New Orleans, LA), presents a second-look surgery 6 weeks after CuffMend™ augmentation, showing incorporation and vascularization of ArthroFlex® human dermal allograft.
ArthroFlex is a registered trademark of LifeNet Health.

CuffMend™ Rotator Cuff Augmentation: Second-Look Surgery at 6 Weeks

Hi, my name is Misty Surrey from New Orleans, Louisiana, and I'd like to share with you a cuff mend second look case. So our patients, a 40 year old male, he's a military recruiter and he's a recreational bodybuilder. He came in with left shoulder pain after an incident at the gym. Basically he was lifting. He had a pop in his biceps three weeks prior to presentation and he came in. So at this point on physical exam, he had pain in his biceps. He had pretty good range of motion. He was just a hair weak in his rotator cuff and a positive near positive. Hawkins and O'Brien signs on x ray. Nothing significant. No significant arthritis or dislocation or any bony changes. Now an MRI. What we see here is a small ten by ten millimeter partial thickness under surface. Tearing to the rotator cuff did have an upper border sub scap tear with a slap as well. So at this point I decided with the patient that we would proceed with a biceps tenodesis a slap repair, and to address that rotator cuff damage cuff mend augmentation of the partial thickness tearing. So in the operating room, what I found was a type eight slap. There was no evidence of any damage, and the partial thickness rotator cuff damage was confirmed. That we saw in the MRI was about 30%. On the articular side of that rotator cuff, I proceeded with an upper border subscapular repair and a decompression and a repair of that slab. Type eight to address the partial thickness articular sided cuff damage. I proceeded with a cuff mend augmentation of the rotator cuff. So here's a clip of the cuff augmentation part of the procedure. I attached the graph medially with fiber stitch RC anchors both anteriorly and posteriorly with a mattress stitch. I do prefer to use the nanoscope with this part of the case, so I can see the implants deploy on the undersurface of the rotator cuff. I used the two fiber stitches medially, and then two push locks laterally to fix the cuff bin graft. Here's what the final augmentation looked like with the graft nicely tensioned and not over tensioned. So unfortunately, five weeks after surgery, the patient fell and then fell again and had a Popeye deformity that he noticed after the second fall with a significant increase in pain. So he came in and on physical exam. At this point, he had a positive Popeye deformity with a positive speeds and positive Jurgensen signs, as well as a little bit of weakness and decreased range of motion. So an MRI was obtained at this point showing complete disruption of the proximal biceps with about three centimeters of retraction, as we can see here. And the superior aspect of the subscapular was torn as well. So at this point, the plan was to do an open subpectinata thesis with a revision repair of the superior aspect of the subscapularis. So the intraoperative finding confirmed the MRI findings of the torn biceps and the upper subscapularis tear. So I proceeded with an upper subscapular revision repair as well as an open subpectinata thesis. With the second look, I was able to see the great incorporation of the kerfman graft into the rotator cuff tissue. So to probing here you can see the the continuity of the graph to the native tissue, as well as the vascularity of the graft already at the six week time point. Now there is no inflammatory reaction at all. There was no bursitis. This is what it looked like when I put the scope in to the shoulder. So this was this is a very, very convincing second look that shows us great incorporation of this graft at this time point of six weeks. So what happens on the undersurface of the rotator cuff? You can see the complete synovial ization of the implants on the undersurface of the cuff, with no reaction whatsoever. So at the six month time point, he's doing very well. He's quite happy. He has a sane score of 90, he has zero out of ten pain and he's back to weightlifting. His motion is very good and he's got great strength in terms of cuff testing. So this was not an isolated case. I had another patient that also had a subsequent trauma after surgery that we got histology on as they went on to a shoulder arthroplasty after their massive rotator cuff repair that was augmented with cuff meant. And we can see here that there's significant revascularization, active tissue remodeling and decellularization of the graft. This was another patient, also seven months out of surgery that had an AC joint trauma that I got a second look on. That also shows excellent incorporation of the Kauffman graft. To conclude, Kauffman has been a game changer in my practice. With my experience of over 300 cases, I have found Arthur Fleck's to be the perfect combination of mechanics and biology. It's been a paradigm shift for my patients, giving my patients the best chance of healing of their rotator cuff tissue. Thank you.

This animation demonstrates the features and benefits of the tensionable knotless biologic tuberoplasty technique for the treatment of massive irreparable rotator cuff tears.

Tensionable Knotless Biologic Tuberoplasty for Treating Massive, Irreparable Rotator Cuff
Tears

Justin W. Griffin, MD (Virginia Beach, VA), demonstrates a new innovative technique, biologic tuberoplasty, for irreparable rotator cuff tears. He uses this simple technique to fixate the ArthroFlex dermal allograft to the tuberosity, providing a protective covering that may prevent humeral-acromial contact for pain relief in low-demand patients.&nbsp; 

 
ArthroFLEX® is a registered trademark of LifeNet Health.

Tensionable Knotless Biologic Tuberoplasty Technique

Today we're going to be demonstrating biologic tuberoplasty, which is a new technique for management of irreparable rotator cuff tears. Here we have everything we need for performing the procedure in a fast and efficient way. We're going to be using two medial row self-punching knotless FiberTaks. And then laterally we'll use 4.75 SwiveLock for our graft. We have a three millimeter dermal allograft. So here we have a right shoulder. We have several different portals that are important for doing the procedure. I always start from my posterior portal when I'm doing my intra-articular work. We'll be working from a more lateral viewing portal, and then our anterior superior portal is going to be our working portal for placement of the graft. Our suture anchors will be placed percutaneously just off the acromial edge. And then finally we have our anterior portal, which can be helpful for suture management. So this represents our typical appearance of a massive irreparable tear. You can see in the back there's some preserved infraspinatus that we can use to repair to our graft at the end. With side to side sutures. You can see the tuberosity is bare and in the front are subscapularis is intact. So we have two options for how to measure for our graph. So once we get a sense of where the graft is supposed to be, typically I will be decorticating just a little bit on the tuberosity for graft healing. In many cases I'll medialis the footprint just slightly to allow for maximal graft coverage. So we're going to go ahead and measure for our graft. We can place our measuring device here. And we can see that we're measuring approximately 30. Because we know the graft is going to stretch when we place it. We're going to undersize this and cut our graph to 25. So then we're going to get a sense for what our lateral to medial coverage needs to be. For the tuberosity you can see that it's around 20 to 25. We're going to undersize this to 20 which is very typical for this procedure. So while I'm working on placing my medial row anchors, my assistant can prepare the prepare the graft on the back table. Here I'm going to place two luggage tag sutures through the lateral aspect of the graft. Medially we're going to utilize links for passing our repair sutures. This allows us to do all of our suture management more on the back table, as opposed to having to do this up at the side of the patient. So this is really all the preparation that's needed for your graft. So next we'll place our anchors percutaneously. So first we're going to place our Anteromedial anchor. This is our Self-punching Knotless FiberTak. So we can just set this and then leave it. Percutaneously placed there and move on to placement of our posterior anchor. So you can see we have a nice distance between our anchors to get maximum tuberosity coverage. So next I'll retrieve the repair suture as well as the shuttle suture from our anterior anchor. It's important to make sure that we keep these separated more anteriorly in the passport. And then the more posterior. I'm going to stay towards the back side of my passport when I retrieve that. So we've brought our graph to the patient. Next I'll take my anterior repair suture. Just making sure that I'm not twisting anything here. And we'll place this very easily through the link. So our anterior repair sutures through our graft. We'll do the same thing posteriorly. So next we'll convert our anterior knotless FiberTak repair suture. We're going to pull it up to the line. So we'll provisionally tension these. We've got both of our repair sutures out our percutaneous portals so that we're not putting a lot of tension on these. So while we're placing this tension and bringing our graft in, your assistant is placing tension on these lateral cinches so that the graph naturally folds on itself, which allows for easy insertion. So we can progressively tension this in anteriorly and posteriorly. Sometimes you just need to take a little grasper to get this through your your 12 passport here. But it slides in pretty easily. We have very nice coverage of that medial tuberosity. So our next step is to place our lateral row anchors. So typically for placing my anterior anchor I find the biceps groove. And then I move just posterior to that. And that's going to be a good spot for our anterior anchor. Alright. So we're going to punch for our anterior anchor. And this will be our final anchor. So we have our final tuberosity coverage here. This is our tuberoplasty. You can see we have very nice anterior coverage. We've covered all the way up to the remaining infraspinatus. So we can place our side to side sutures. And we've retained our medial repair sutures so we can final tension these. Now as you can see there's very nice coverage here. So we're going to do some final tensioning just to make sure that everything's nice and solid medially. But we really don't have much that we need to take out here. I think everything's tensioned really well. As a final step, we have the option of placing a few side to side sutures through not only our infraspinatus, but also the subscapularis if possible. With the tuberoplasty, I'll keep my patients in a sling for approximately six weeks with passive range of motion, and let them begin active range of motion after coming out of the sling, and begin strengthening at eight weeks. Postoperatively.

The Knotless FiberTak® biceps implant system offers a knotless, all-suture anchor solution to perform an onlay proximal biceps tenodesis at any location. The implant uniquely integrates two individual tensionable knotless mechanisms within a single FiberTak sheath. The blue FiberWire® repair suture passes around the biceps tendon, while the white suture loop is retrieved through the tendon. The blue repair suture is retrieved through the loop, and both are tensioned to complete the tenodesis.

Knotless FiberTak® Biceps Implant System for Proximal Biceps Tenodesis

In the subacromial space. Insert a cannula in line with the intended anchor insertion site. Place the drill guide on the bony surface of the proximal humerus at the desired tenodesis location. Drill a pilot hole using the 3.0mm. Drill until the positive stop on the drill guide is reached. Keep the drill guide in place and insert the Knotless FiberTak implant through the guide. Lightly tap on the inserter handle until it is flush with the drill guide. Remove the black suture release tab to remove the sutures from the inserter handle. Lightly pull evenly on the suture limbs to set the anchor in the bone. Using a suture retriever, shuttle the solid blue FiberWire. Repair suture under and around the biceps tendon to the opposite side of the white suture loop. Insert the loop and tack SwiftStitch. Suture passer and penetrate the biceps tendon at the desired tenodesis location. Retrieve and shuttle the shuttle the white tensioning suture loop through the tendon. Using a suture retriever. Retrieve the solid blue FiberWire. Repair suture through the white TensionLoc suture loop. Load the blue FiberWire. Repair suture through the shuttle link suture loop and fold the repair suture limb at the purple indicator mark. Pull the tape end of the shuttling suture to shuttle the repair suture through the knotless mechanism and tension the repair suture around the biceps tendon. Tension the white suture limb to lock the tendon to the blue circumferential stitch. Pull each suture limb sequentially to ensure adequate tension and a secure tendon reduction. Cut the suture. Limbs. Excise the biceps tendon 5 to 10mm proximal to the repair, and remove the remaining tendon stump from its attachment to complete the repair.

This animation demonstrates the arthroscopic bone block cerclage technique for glenoid bone loss, which preserves the integrity of the subscapularis and provides a metal-free fixation of a bone graft using FiberTape® cerclage. The procedural steps show in detail the use of the TransGlenoid drill guide, as well as all the components of the procedure kit.

Bone Block Cerclage

The bone blocks are. Collage technique for glenoid bone loss is an arthroscopic surgical procedure that preserves the integrity of the subscapularis and provides a metal free fixation of a bone graft after soft tissue release and bone preparation with direct vision from an anterolateral portal. The glenoid defect is measured using an arthroscopic measuring probe through an anterior inferior portal. The middle of the defect is calculated to aid in correct placement of the drill guide. Insert the trans glenoid guide hook through a posterior portal and place the anatomic hook flush to the glenoid surface as close as possible to the center of the defect. The hook of the guide is curved to sit flush to the glenoid. Anatomy and features A ten degree safety angle incorporated in the shaft. The V laser mark projects to show the expected exit points of the drills. Select the desired offset 5 or 7mm and introduce the drill sleeve until firm contact is felt against the posterior scapula. Take note of the intraosseous distance depicted by the laser marks on the drill sleeve. Using the short cannulated drill. First drill a three millimeter bone tunnel across the glenoid with direct visualization of the defect and drill exit points. The drill tip should exit anteriorly as the corresponding laser mark on the drill. Lines up with the drill sleeve. Use the long cannulated drill in the same manner for the second bone tunnel. Remove the drill sleeve and use the slot in the handle to remove the guide hook. Leaving the drills in place. Drill two tunnels through the bone block, one centimeter apart and corresponding to the medial glenoid. Offset of the previously drilled tunnels through the glenoid. Remove the pins from the cannulated drill. Pass a SutureLasso wire through the cannulation of the drill from posterior to anterior, leaving the loop of the wire posteriorly. Retrieve the wire out of the joint through the rotator interval and then remove the drill. Pass another wire through the cancellation of the second drill and retrieve through the rotator interval, leaving the loop anteriorly. Replace the wires with FiberLink and TigerLink sutures, making sure to leave the loops as done previously. Use the loop of the FiberLink suture posteriorly. Pass both single limbs of the FiberTape and TigerTape. Cerclage sutures through the same glenoid tunnel, through the rotator interval, and out the out the interior portal. Use the Mega Loader to pass both cerclage sutures through the cancellous side of the bone block, and then back through the other drill hole. Use the remaining TigerLink suture loop to transport the cerclage sutures through the rotator interval and the other glenoid bone tunnel. Introduce the graft and maintain orientation while pulling on the sutures posteriorly. Pull on each limb to individually remove the slack. Introduce the single limb of the FiberTape cerclage suture into the knot of the TigerTape. Cerclage suture using the orange loader. Remove the loader and make sure to slide the FiberTape cerclage suture until the tape portion and slightly tighten the knot. Repeat the process for the TigerTape cerclage suture and FiberTape cerclage. Not grasp and pull the individual sutures a few centimeters at a time, alternating between the suture pairs to reduce the knots down to the bone. To make sure the knots are fully reduced to the bone. Load the FiberTape cerclage suture into the tensioner and lightly tension until resistance is felt. Repeat this step with the TigerTape cerclage suture. Cut the FiberTape cerclage suture to separate the limbs. Throw a half hitch and reduce the knot to the bone. Insert the hitching suture limb into the tensioner and tension to around 30, while having direct visualization of the anterior portion of the bone graft in the cerclage SutureBridge. Apply additional alternating half hitch knots and cut the sutures. Repeat the same steps for the TigerTape cerclage suture. Reattach the CapsuleLink labral complex to the anterior glenoid rim with knotless 1.8 FiberTak anchors to avoid damaging the construct. Use flexible non fluted drills when placed between the bone tunnels.

This animation provides an overview of the features and surgical techniques of the Knotless AC TightRope® implants for the treatment of acromioclavicular joint separations. For arthroscopic procedures, the dual construct features a #6 TightRope suture preassembled into a clavicle insert and an attachable Dog Bone™ button. For open procedures, the implant features the same suture and clavicle insert technology, with a large pec button preloaded onto an inserter, allowing surgeons to perform an open or mini-open “push-through” technique.

Knotless AC TightRope® System

The Knotless AC TightRope repair system is designed for the reduction and stabilization of acute and chronic acromioclavicular joint separations. The implants feature a titanium clavicle button with suture locking technology and a stabilizing cup insert for arthroscopic procedures. A dog bone button is attached to the suture loops after they are past antegrade through the three millimeter bone tunnels. For open procedures. A large pec button is preloaded onto an inserter, which allows surgeons to perform an open or mini open push through technique without having to use a scope or access beneath the coracoid. The Knotless AC TightRope implants feature a six TightRope suture adjustable loop technology, and a proprietary five point suture locking design to resist cyclic displacement of the construct and avoid loss of reduction of the repair. For arthroscopic procedures. First, reduce and maintain the AC joint in the correct position and then insert the aiming hook through a low interior portal, placing the drill sleeve on top of the clavicle. Drill three millimeter tunnels through the clavicle and coracoid. Remove the guide, leaving the drill in place. Remove the stylet from the drill. Pass a SutureLasso wire through the cannulation, leaving the loop superiorly, and retrieve the wire through an interior portal. Remove the drill, leaving the wire in place. Shuttle the implant antegrade through the clavicle and coracoid and out of the cannula anteriorly. Attach a dog bone button to the loops and introduce the button under the base of the coracoid. Sequentially, pull on the cinching suture. Limbs 1 to 2cm at a time to reduce the construct. Once correct reduction is confirmed, cut the remaining suture limbs at least three millimeters from the SutureBridge to complete the repair. For an open or mini open approach, drill a Drill a 3.7mm tunnel through the clavicle and coracoid. Fluoroscopy may be used to confirm proper tunnel placement. Insert the knotless AC TightRope implant through the tunnels using light taps on the inserter handle. Once again, fluoroscopy may be used to confirm the implant is properly deployed through both tunnels. Remove the red pull tab from the handle to release the implant. Turn the stylet counterclockwise to release the coracoid button from the tip of the inserter. With the inserter still in place, pull on the clavicle button to seat the coracoid button under the coracoid. Once correct deployment is confirmed, remove the driver from the tunnels. Sequentially, pull on the cinching limbs 1 to 2cm at a time to reduce the construct. Once correct reduction is confirmed, cut the remaining suture limbs at least three millimeters from the SutureBridge to complete the repair.

Arthroplasty Shoulder

This animation presents the features and benefits of the Univers Revers™ humeral implants.

Univers Revers™ Total Shoulder System—Versatility. Simplicity. Performance.

This animation illustrates the features and benefits of the Eclipse™ total shoulder arthroplasty system.

Eclipse™ Total Shoulder Arthroplasty System: Features and Benefits

This animation provides an overview of the FxBridge™ tuberosity repair system and the surgical technique used in conjunction with Univers Revers™ implants to treat proximal humeral fractures.

FxBridge™ Tuberosity Repair System: Reverse Total Shoulder Arthroplasty

Identify the proximal humeral fracture pattern. The humeral head fragment is removed from the wound. Begin the repair by passing the blue number two FiberLink inside out through the infraspinatus tendon at the bone tendon junction. Repeat this process with the white black number two. Tigerlink going through the inferior portion. Next, pass the number two FiberLink inside out through the superior portion of the subscapularis tendon. Repeat this process with the number two TigerLink through the inferior portion. Prepare the glenoid per the specific glenoid system surgical technique being used. Then prepare and trial the humeral components. Remove the humeral trials and drill two holes in the lateral side of the bicipital groove with the 2.0mm drill bit. Drill the holes 1 to 2cm distal to the humeral shaft. Fracture line. Pass the black blue 1.7mm FiberTape in an outside in, then inside out fashion. Repeat this with a second 1.7mm FiberTape. After assembling the suture cup and humeral stem, Pass the white black 1.7mm TigerTape through the two distal row eyelets of the SutureCast. Then pass the blue 1.7mm FiberTape through the proximal two eyelets. Repeat the suture passing for the posterior eyelets. Implant the humeral prosthesis and place the final humeral insert on the posterior side. Take the suture tails from the blue FiberTape and feed them into the blue FiberLink looped end. Repeat the previous steps for the TigerTape and TigerLink, then shuttle the sutures through the greater tuberosity. Reduce the shoulder on the anterior side. Take the suture tails from the blue FiberTape and feed them into the blue FiberLink looped end. Repeat the previous steps for the TigerTape and TigerLink. Shuttle the suture through the subscapularis. Take one limb of the blue FiberTape from the lesser tuberosity, and one limb of the blue FiberTape from the greater tuberosity, and tie them together. Note the strands are free moving and won't tension when being tied together. Take one limb of the white black TigerTape from the lesser tuberosity and one limb of the white black TigerTape from the greater tuberosity and tie them together. Take the remaining blue FiberTape from the lesser tuberosity and the remaining white black TigerTape from the greater tuberosity, and tie them together. These remaining strands allow for the construct to be tensioned when tied. Take the remaining white black TigerTape from the lesser tuberosity, and the remaining blue FiberTape from the greater tuberosity, and tie them together after the suture construct has been tied. Pass and tie the vertical tension band sutures starting with the anterior whole. Pass one limb of the black blue FiberTape up through the superior aspect of the subscapularis, and then through the superior aspect of the infraspinatus. Take one limb of suture from the posterior whole and tie it to the past suture. Repeat the process for the remaining black blue FiberTape working posterior to anterior.

&nbsp;Shoulder360

Below is a collection of resources for you to learn more about the latest innovative products and techniques in shoulder sports medicine and arthroplasty. From shoulder repair to reconstruction, Arthrex has you covered.

Shoulder360

Shoulder360

Knotless 1.8 FiberTak® Soft Anchor for Shoulder Instability Repair

Live Surgery: Instability Repair With Remplissage Using Knotless FiberTak® Soft Anchors

FiberTak® SpeedBridge™ Implant System Features and Benefits

FiberTak® SpeedBridge™ RCR With 2.6 FiberTak RC Anchors for Delaminated Rotator Cuff Tears

CuffMend™ Rotator Cuff Augmentation System Features and Benefits

CuffMend™ Rotator Cuff Augmentation: Second-Look Surgery at 6 Weeks

Tensionable Knotless Biologic Tuberoplasty for Treating Massive, Irreparable Rotator Cuff Tears

Tensionable Knotless Biologic Tuberoplasty Technique

Knotless FiberTak® Biceps Implant System for Proximal Biceps Tenodesis

Bone Block Cerclage

Knotless AC TightRope® System

Univers Revers™ Total Shoulder System—Versatility. Simplicity. Performance.

Eclipse™ Total Shoulder Arthroplasty System: Features and Benefits

FxBridge™ Tuberosity Repair System: Reverse Total Shoulder Arthroplasty