ARTHROSCOPIC ROTATOR CUFF REPAIR USING THE PARACHUTE TECHNIQUE: RESULTS OF 170 PATIENTS

Objective

Arthroscopic rotator cuff repairs now yield a similar footprint as open procedures with several advantages, including reduced tissue trauma, post-operative pain, swelling, and concern about the deltoid attachment. We present a new simple and reproducible technique for arthroscopic rotator cuff repair.

Methods

Sutures are placed through the full thickness of the rotator cuff. The suture is tied in the following manner:

1. Traction is released, the assistant maintaining the arm in abduction and applying tension on the anterior cuff sutures while the posterior cuff sutures are tied. The procedure is repeated for the anterior cuff suture; and

2. One suture strand from the anterior cuff and one suture strand from the posterior cuff are tied. The procedure is then repeated using the second strand from the anterior cuff and second suture strand from the posterior cuff. This suture and knot tying technique snugs the cuff down to the prepared tuberosity and restores the articular footprint of the cuff. This study retrospectively evaluated the clinical outcome of 170 patients who underwent arthroscopic cuff repair using this technique.

Results

The mean age of the patients was 56 years (range, 29-78 years), and the mean follow-up was 38 months (range, 12-60 months). 25 % patients had a cuff tear < 1 cm, 45 % with a cuff tear size 1-3 cm, 25 % with a cuff tear size 3-5cms and 5 % with a cuff tear larger than 5 cms. All patients had improvements in pain, range of motion and strength. Significant improvements were demonstrated for Constant scores (from 42 to 87 points, P < .001). 92 % of our patients were satisfied. 80 % of patients returned to pre-injury levels of work and leisure activities.

Conclusion

This study demonstrates the successful clinical outcome of the parachute technique for arthroscopic cuff repair.