AANA19 Surgery Simulcast Access Pass: Rotator Cuff Repair (Morse/Jazrawi)-Rotator Cuff Repair: Live Surgery Simulcast

Video Transcription

Video Summary

Adam Morris from Florida Orthopedic Institute demonstrates a rotator cuff repair on a 71-year-old female with a medium-sized, full-thickness retracted tear following a fall. The surgery employs a beach chair position with a spider arm holder for stability. A double-row repair is favored for larger tears to recreate the tendon footprint using Smith and Nephew anchors, which promote blood flow and bone incorporation. Portal setup includes standard posterior, accessory posterior lateral, lateral, and anterior portals for visualization, suture passage, and subacromial decompression.<br /><br />After clearing the rotator cuff edge, Adam discusses anchor choice, noting larger 5.5 anchors for suspected poor bone quality and using tapping rather than punching to preserve bone and anchor integrity. Suture passing is done through multiple portals to reduce tissue tension and avoid suture tearing. In older patients, biceps tenotomy is preferred over repair for degenerative SLAP tears. The lateral row anchors are placed carefully to avoid bone damage, with bailout options including stacking anchors when fixation is poor due to soft bone. Knot tying is done from lateral portals with fisherman's knots and half hitches.<br /><br />Throughout, Adam emphasizes minimizing tissue tension, optimizing anchor placement, and adapting technique for bone quality. The case concludes successfully with a well-fixed repaired rotator cuff and methods to manage challenges such as short sutures or dog-ear defects.

Asset Caption

Live Surgery Simulcast-Thursday, May 2nd, 2019 (Morning)

Keywords

rotator cuff repair

double-row repair

Smith and Nephew anchors

beach chair position

biceps tenotomy

subacromial decompression

arthroscopic portals