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SISA repairs Rotator Cuff Tear without implantation

December 05,2014  

SISA repairs Rotator Cuff Tear without implantation
City-based doctor designed new device called Arthrotunneler to repair Rotator Cuff Tear, an implant free technique.

SISA REPAIRS ROTATOR CUFF TEAR THROUGH AN INNOVATIVE TECHNIQUE, ENSURING A MORE BIOLOGICAL & NATURAL HEALING THROUGH 'ARTHROSCOPIC TRANSOSSEOUS CUFF REPAIR' - AN IMPLANT FREE TECHNIQUE

Hyderabad, 4th December, 2014: City-based renowned Shoulder & Knee Specialist Dr. Raghuveer Reddy & Orthopaedic surgeon, SISA centre for Advanced Arthroscopy, Joint reconstruction and Sports Injuries, performed an innovative procedure - Arthroscopic Transosseous Cuff Repair, to repair Rotator Cuff Tear using a specially designed device by him, called ‘Arthrotunneler'. This new procedure is devoid of an implant and therefore ensures biological and natural healing of the rotator cuff tear.

Dr. Raghuveer Reddy mastered the technique of arthroscopic transosseous cuff repair from the USA based inventor, Dr. Sumant Krishnan, himself and is the first surgeon in India to perform the procedure.

Rotator cuff is a structure around the shoulder joint; which covers the joint like a cuff and functions as joint stabilizer. It is made up of four muscles; viz. Subscapularis, Supraspinatus, Infraspinatus & Teres Minor. Tear of any of these muscle or all the muscles is known as rotator cuff tear leading to shoulder joint pain, restricted joint movement, weakness of shoulder.

Treatment of rotator cuff is through surgical repair, which consists of fixing back torn cuff to the original site i.e cuff footprint. The repair technique for cuff tears has gone through various transitions, starting from open transosseous, to mini open transosseous, to mini open anchors, to arthroscopic anchors.

The traditional open transosseous rotator cuff repair gives excellent results by achieving optimal fixation of tendon to bone and has been the gold standard for rotator cuff surgery with excellent long-term results, but was associated with the disadvantage & risks of open surgery & associated morbidity.

In the last few years, different arthroscopic techniques using suture anchors have been developed to increase the tendon–bone contact area in an attempt to reconstitute a more anatomic configuration of the rotator cuff footprint while providing a better environment for tendon healing and to minimise the morbidity associated with open surgery. However, the anchor-based techniques have still not replicated the traditional open transosseous repair.

Taking all these into consideration a new technique of arthroscopic transosseous cuff repair was developed by Dr. Sumant Krishnan. Dr. Raghuveer Reddy who has learnt this technique, has been practicing it with good results.

This new technique is performed arthroscopically using a special device called Arthrotunneler which is currently being imported from U.S.A. In this technique with the help of arthrotunneler, two tunnels are made one just lateral to articular cartilage of humeral head and another tunnel is made 15 mm down from the first tunnel on the lateral aspect of humerus, thus creating a stronger bone bridge in contrast to weaker tunnel which was seen previously in open method.

The advantage of the technique is that, in this no implants are used for repair, only absorbable threads are used which are passed through tunnels to repair the cuff and thus the patient does not have any implant in his body, lifelong. Another important advantage is that as the tunnels are drilled through the bone, the bone marrow which contains healing factors is stimulated & comes in contact with repair site, thus resulting in more biological & natural healing.

The major benefit of this instrument is that it can also be done by general Orthopaedic surgeon using mini open technique.

Presently, the device -Arthrotunneler- is being imported from the USA. To make the process cost-effective, Dr. Raghuveer Reddy in collaboration with a Mumbai based Orthopaedic instrument & Surgical company, intends to indigenously manufacture the instrument.

Dr. Raghuveer has performed nearly 21 cases so far using this technique in SISA centre for Advanced Arthroscopy, Joint reconstruction and Sports Injuries. All his patients are doing extremely well as confirmed clinically & also by MRI. This technique results were presented in recently conducted 13th Indian Arthroscopy Society Congress October 2014 and won great appreciation from Orthopaedic surgeons from India and abroad. The adoption of this technique will greatly benefit Indian patients.