DR SHEKHAR SRIVASTAV Sr Consultant- Knee & Shoulder Arthroscopy

Sant Parmanand Hospital,Delhi

MINI OPEN ROTATOR CUFF REPAIR- TIPS

Open Repair

Mini-open repair

Arthroscopic assisted Mini-open Repair

Arthroscopic Repair

Rotator Cuff Repair

Can be done by non-arthroscopic Orthopedic surgeon

Transosseous fixation- stronger and better healing potential.

Long term results comparable to Arthroscopic fixation

Mini Open Advantage

Full ȮThickness RC tear

Approach

Rotator Cuff Mobilisation & Repair

Sub-Acromial Decompression

Post-op Rehab

Mini Open Rotator Cuff Repair

Positioning Ȯ Beach Chair/ Lateral

Skin Markings

Skin Incision

Deltoid split

Approach

Lateral with traction

Positioning

Planning & Skin Markings

H

L P

A

Skin Incision

L

POST

ANT

H

Deltoid Split

Deltoid Split

Bursa Excision

Bursa Excision

Identification

Anatomy

Mobilisation & Excursion

Footprint Preparation

Rotator Cuff Fixation

Rotator Cuff

Cuff Identification

BURSA

CUFF

Cuff Identification

Holding Sutures

Holding Sutures

HH

sn

Rotator Cuff Mobilisation

Holding Sutures

Humeral Footprint

dd

Rotator Cuff Fixation

rt

Rotator Cuff Fixation

Anchors

Cuff Bite

Cuff Bite

Tightening Sutures

Completed Repair

s

RC Repair

Repaired cuff

e

s

Sub-Acromial Decompression

Sub-Acromial Decompression

Difficult access and Visualisation

Inability to address intra-articular problems

Trauma to Deltoid

More pain in post-op & early recovery period

Post-op stiffness

Mini-Open Problems

Mini-open repair can give as good result as an arthroscopic repair

Approach-Aware of the position of Axillary N.

Understand the anatomy of the Cuff tear

Mobilise cuff properly so that the cuff is not fixed in too much of tension

Use of arthroscopic instruments- very helpful

Can give better result if combined with diagnostic arthroscopy and management of intra-articular problems

Take Home Message

Thank You