Name: Strength and Reliability of the SpeedBridge™ Repair
Uploaded: 2017-11-01T00:00:00Z
Channel: Arthrex
Description: Peter J. Millett, MD, MSc, (Vail, CO) describes his 5‐year results using knotless SwiveLock ® suture anchors combined with FiberTape ® suture for double‐row SpeedBridge™ rotator cuff repairs. Dr. Millett also shares 2 clinical cases highlighting the resilience of the SpeedBridge repair after his patients experienced significant postoperative shoulder trauma.

Peter J. Millett, MD, MSc, (Vail, CO) describes his 5‐year results using knotless SwiveLock® suture anchors combined with FiberTape® suture for double‐row SpeedBridge™ rotator cuff repairs. Dr. Millett also shares 2 clinical cases highlighting the resilience of the SpeedBridge repair after his patients experienced significant postoperative shoulder trauma.

Not Hidden

English  - en

video

VPT1-00870-EN | B | Strength and Reliability of the SpeedBridge™ Repair

Peter J. Millett

Human

Surgeons presenting one or more clinical cases

Chirurg:innen präsentieren einen oder mehrere klinische Fälle

Videos von Fallpräsentationen

Case Presentation Videos

Cirurgiões que apresentam um ou mais casos clínicos.

Vídeos apresentações de casos

Cirujanos que presentan uno o más casos clínicos.

Video presentaciones de casos

Strength and Reliability of the SpeedBridge™ Repair

Hello, my name is Peter Millett and today we're going to be talking about SpeedBridge rotator cuff repair. I'm going to share with you some of our mid-term outcomes that we've had with the double row rotator cuff repairs, and also demonstrate the strength of the SpeedBridge repair with some patients who've had unfortunate trauma after their repair. First of all, what is a SpeedBridge rotator cuff repair? Well, it's a double row, knotless linked self-reinforcing rotator cuff repair construct. It uses SutureTape and vented, fully threaded anchors. It has a number of advantages. It minimizes the surgical steps with only two medial row passes. It maximizes tended to bone fixation strength. It optimizes tendon to bone healing. It enhances surgical precision and speed. And as I'm going to demonstrate, it improves outcomes for patients with rotator cuff tears. This is some recent data we've had on my patients who have had double row rotator cuff repair. We looked at patients who were a minimum of five years out from their repair and we studied their outcomes. We had 259 patients that met the inclusion criteria. The mean follow up was 6.6 years. All patients, as I mentioned, were all a minimum of five years. And our revision rate for revision rotator cuff repair was 5%. 13 patients. Our mean Ace score was 92.7, and our median patient satisfaction was ten on a scale of 1 to 10. When we looked at predictors of success, we found that primary repairs tended to do better than revision rotator cuff repairs. And when we looked at other predictors that you might think might influence this, the chronicity of the tear as defined by repair within three months did not influence the outcome. And also the number of tendons involved did not influence the outcome. If it was an isolated supraspinatus tear combined supra and infraspinatus tear combined supra and SpeedScap tear, or if it involved all three tendons, the outcomes were similar. Surprisingly, this is the Kaplan-Meier survivorship, which you see is excellent. 93% at five years outcome. So very good survivorship. And you can see an example there of a video of demonstrating the SpeedBridge rotator cuff repair for a crescent shaped tear. This is a six anchor repair with an extended SpeedBridge construct. So very good midterm outcomes which is very reassuring for us. So we know that the SpeedBridge gives good outcomes. We know that it's strong. Certainly the biomechanics of this type of repair have been studied extensively in the lab. You can see on the slide to the right there an image of an arthroscopic repair with a SpeedBridge and an extended SpeedBridge construct demonstrating repair strength that's equal to an intact tendon. And in a series of my patients, 517 cases, 87% of the patients were cleared for full activities at approximately three and a half months. Postoperatively. I'll just show you a few case examples of post-operative trauma after rotator cuff repair. This is an example here of a 71 year old gentleman who was a recreational biker, hiker, skier, and horseback rider. He was thrown from his horse and suffered this massive left shoulder rotator cuff tear. You see on the MRI on the coronal view here a full thickness supraspinatus tear with retraction. He underwent operative fixation with an extended six anchor SpeedBridge repair in his left shoulder. Here you see the intraoperative images demonstrating the typical SpeedBridge construct, with anchors medially taped, bridging across to a knotless construct with a double row fixation with the vented anchors laterally by four months. Postoperatively. He had returned to full activities, and in a subjective shoulder value he rated his shoulder at 100%. 11 months later, the following summer, he was back to his usual activities and he was in a bike crash, going approximately 40 miles an hour. You can see on these x rays he sustained a left eidsberg type two transverse glenoid fracture. He had seven rib fractures on the same side as well as a hemopneumothorax, and he had a degloving injury to his scalp. He underwent immediate treatment for his scalp, lung, and rib injuries. One week later, when he was discharged from the hospital for his hemopneumothorax, he presented with shoulder pain. It was a difficult exam due to his rib fractures. The MRI showed that the SpeedBridge looked like it was intact, but he had this displaced glenoid fracture. So he went to the O.R. for operative fixation of his glenoid fracture. Here, you can see what we found on his intraoperative images and intra-articular view of the left shoulder, showing the rotator cuff to be intact on the left, and then a bursal sided view on the right, also showing the left shoulder with the rotator cuff completely intact. So his SpeedBridge extended SpeedBridge construct was able to withstand this bike crash. That was enough trauma to injure his glenoid and fracture it. He underwent operative fixation of his glenoid fracture with arthroscopic reduction internal fixation, and three months later he was fully recovered and he was back to full activities. Another case example this is a recent case that I had in my practice is a 51 year old woman with a left rotator cuff tear after a fall while skiing. She had a crescent shaped supraspinatus tear and underwent a typical SpeedBridge rotator cuff repair. You can see here the intraoperative pictures for anchor SpeedBridge rotator cuff repair. Two anchors medially, two passes of the tape. The four suture tapes are then spread out and compressed laterally into a lateral row of vented SwiveLock anchors. By six months post-operatively, she was doing very well and had returned to full activities, and we discharged her from our practice. Well, one month later she went back to skiing and she fell, suffering this proximal humerus fracture. You can see here a valgus impacted, minimally displaced proximal humerus fracture on the ipsilateral shoulder. And you can also see evidence of the prior biceps tenodesis. It was a difficult exam, as you might imagine, with a fracture. We were concerned about injury to the rotator cuff. So she underwent an MRI. You can see the images here on the MRI. The SpeedBridge rotator cuff repair was completely intact. She was treated non-operatively and subsequently has had a good outcome.

Strength and Reliability of the SpeedBridge™ Repair

Related Pages

Shoulder

SpeedBridge™ Double-Row Technique

Procedure

Shoulder

SpeedBridge™ Implant System

Product

Shoulder

SwiveLock^® C Anchor

Product

Strength and Reliability of the SpeedBridge™ Repair

Related Pages

Shoulder

SpeedBridge™ Double-Row Technique

Procedure

Shoulder

SpeedBridge™ Implant System

Product

Shoulder

SwiveLock® C Anchor

Product

SwiveLock^® C Anchor