AANA Middle East Arthroscopy Master Course (International)-Arthroscopic Rotator Cuff Repair

Arthroscopic Rotator Cuff Repair

Pdf Summary

This document by Dr. Joseph C. Tauro focuses on arthroscopic rotator cuff repair, emphasizing tear pattern recognition, repair techniques, and advanced treatment options.<br /><br />Rotator cuff tears vary in pattern: crescent (short and wide), longitudinal “U” shaped (long and narrow), “L” shaped (combining crescent and longitudinal), and massive contracted tears (>2cm). Proper identification guides the repair approach. Crescent tears are repaired end-to-bone, longitudinal tears side-to-side, and “L” shaped tears with a combination of both.<br /><br />Visualization of the tear is critical—removal of bursal tissue and non-viable tissue allows access to the actual cuff for precise repair.<br /><br />Repair options include single row and double row techniques. Single row repairs are commonly used for small to moderate tears, whereas double row repairs—providing stronger and more anatomical fixation—are reserved for cases with sufficient tendon tissue. Anchor placement and suture technique differ between these methods.<br /><br />Massive tears involve multiple tendons (supraspinatus, infraspinatus, subscapularis) and often require partial repair along with soft tissue releases such as capsule detachment and interval slides to restore mobility.<br /><br />A notable advanced technique is Superior Capsular Reconstruction (SCR), indicated when the supraspinatus is irreparable but the subscapularis and infraspinatus remain intact or repairable. SCR restores shoulder stability by reconstructing the superior capsule, typically using dermal allografts fixed via multiple anchors with double row lateral repair. Success factors include strong adjacent tendon repair, accurate graft sizing, and skilled surgical support.<br /><br />"Orthobiologics" like collagen patches, platelet-rich plasma (PRP), and bone marrow aspirate concentrate (BMAC) incorporating mesenchymal stem cells may augment healing in arthroscopic rotator cuff repair.<br /><br />Overall, precise tear pattern recognition, appropriate repair selection, soft tissue release, advanced reconstruction, and biologic augmentation are key to optimizing rotator cuff repair outcomes.

Keywords

arthroscopic rotator cuff repair

tear pattern recognition

crescent tear

longitudinal U-shaped tear

L-shaped tear

single row repair

double row repair

superior capsular reconstruction

orthobiologics

soft tissue release