Arthroscopic Rotator Cuff Repair Surgery with SAD Dr. Eric Janssen
I'm Dr. Eric Janssen from SportsMED Orthopaedic Surgery & Spine Center in Huntsville AL today's video is an arthroscopic rotator cuff repair with a subacromial decrompression in a 50 year-old male patient who came to our office with pain and inability to use his arm overhead. Here in the operating room we have the patient lying on his side with his left shoulder upward. We mark the portals and place our needle into position and in place fluid inside the joint the fluid is to distend the joint so that we can place our portals inside Here we can see the setup looking at a camera and now looking directly at the camera where we're inside the shoulder joint just cleaning up a little bit of a damage on his labrum or cartilage the first step in this procedures is to make sure that there's nothing interarticular within the joint that could be causing symptoms on top of the rotator cuff tear once again we're just cleaning up the labrum or a little bit of fraying on that area Here we are cleaning the undersurface of the rotator cuff tear from inside the joint the second portion of this procedure is to go into the top space above the joint and here once again looking inside this is the subacromial space the bursa is being cleaned the soft tissues being taken off the undersurface of the bone this is a heat devices used to do that we now have a burr that we will use and a shaver to take off the under surface of the bone We want to flatten it off and not leave any kind of spur that might later damage our repair once again we're smoothing up the under surface of the bone where we cleaned the spur from We will next inspect the rotator cuff in here you can see little tear we're using a shaver just to clean up the edges from it we can lift it up and look down inside of the joint which normally we would not be able to do once again we want to debrid or clean the edge of this tendon so that we can repair it Next we will extend the portal with a little knife and place a cannula inside after removing the cannula we will place a screw down into the bone that has been freshened up the reason for the screw is so that we can have suture attache to the bone and pass it through the tendon to perform the repair here we can see the screw going down inside We will then remove the screwdriver and here you can see the screw buried in the bone and the suture exposed. We will then remove one of the two stitches and place it down inside a cannula so we can pass the suture into the tendon Here we will see the cannula coming inside the joint We will then grasp each individual stitch and pull it outside the shoulder joint. Here we will load it up on a suture passer place the suture passer down inside the cannula and while watching on the screen we will pass the stitch. Here you can see we're pushing the suture from the under surface of the tendon through the superior surface and this suture passer will grasp it back outside We will then do it with the second arm of the suture to create what we call a horizontal mattress stitch. After that's completed will take a second stitch and pass it in a similar fashion Once the sutures have been passed we will tie the knot on each individual suture outside the joint and pass them down through the cannula with this knot pusher you can see the not push outside the joint now inside the joint as we tighten down the stitch will use five knots for each stitch as you can see them being placed down here and lastly, we will use a suture cutter to cut the suture just above the knot Here we can see the second suture we are tying down the knots on like we did the first once this has been completed we will do a similar cutting of the suture above the knot now we can see that the tendon has been reattach back to the bone so that it can heal for more information of this and other procedures please go to w.w.w.
Dot sportsmedalabama dot com.
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