Arthroscopic rotator cuff repair by bony tunnels. A preliminary study

The classic open technique for rotator cuff repair is performed by passing non absorbable sutures in the tendon and through bony tunnels, tied on lateral surface of the greater tuberosity. This procedure has been performed at our institution by arthroscopic means employing the Acufex® guide for the T-fix® instrumentation and the Acufex® suture-punch with dedicated sutures. The technique is described in detail. From December 1998 to May 1999 eleven cases were treated with this technique as an alternative to the reinsertion with absorbable anchors. In the same period 53 reinsertions of the rotator cuff with anchors were performed. The two groups were compared. The mean follow-up was 13.6 months (range, 12 to 16 months). The average post-operative Constant score was 83 points (range, 65 to 97 points) for the patients which had trans-osseous sutures and 84 points (range, 63 to 95 points) for those treated with anchors. No statistical difference was observed between the two groups. No failure of the trans-osseous tunnels manifested. The only post-operative complication concerned a transitory stiffness of the shoulder presenting once in the first group and in four cases in the second group. Its cause was identified in a lack of passive motion in the early post-operative weeks. The proposed technique gave satisfactory early results, comparable to those achieved with the anchors technique. For these reasons the trans-osseous sutures technique revealed to be a valid alternative in arthroscopic surgery of the rotator cuff tears.