An Alternative Rip-Stop Technique for Difficult Rotator Cuff Repairs
Ryan Neeley, DO, a fellow at the Florida Orthopaedic Institute (FOI) in Tampa, was the recipient of a $1000 award for the best abstract presented at the recent 5th Annual Technology and Innovation in Orthopedics Symposium. The symposium was organized by the Holy Cross Orthopedic Institute in Fort Lauderdale, Florida.
Dr. Neeley and his colleagues from FOI and the Foundation for Orthopaedic Research and Education, also in Tampa, introduced a variation on the rip-stop technique for repairing rotator cuff tears that are medial, have lateral tendon loss, or have limited tendon mobility. This technique is intended to improve the suture-tendon interface by infusing the tendon with a single suture tape with multiple passes from anterior to posterior as the rip-stop stitch. A single-row repair is then performed with a simple stitch passed medially to the rip-stop stitch.
For the study, the researchers biomechanically tested the strength of this rip-stop technique compared with that of a single-row repair with simple sutures in 9 matched pairs of cadaveric shoulders (18 total). They hypothesized that they would observe less overall displacement and increased load to failure with the rip-stop technique.
What they found was that the rip-stop technique can increase stiffness, achieve higher failure loads when compared with simple suture repair with no rip-stop, and reduce tendon cut-through. “This study will add to the current body of literature and provide insight to a variation of rip-stop stitch techniques that may help solve the clinical problem of failures occurring at the suture-tendon interface, specifically tendon cut-through,” Dr. Neeley and his colleagues said in the study abstract.
They concluded that their alternative approach to the rip-stop technique may help surgeons faced with challenging rotator cuff tears that involve tendon loss.
Source
Neeley R, Diaz MA, Velasquez S, Gorman RA, Mighell MA. The Biomechanical Effect of Rotator Cuff Tendon Infusion with Suture Tape, a New Technique for Rip Stop. Presented at the 5th Annual Technology and Innovation in Orthopedics Symposium, January 24-25, 2020, in Fort Lauderdale, Florida.