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ARTHROSCOPIC ROTATORCUFF REPAIR WITH A KNOTLESS ANCHOR SYSTEM



Abstract

We assessed a new knotless anchor system (Opus AutoCuff, ArthroCare Sports Medicine), which was designed to repair torn rotator cuffs. This knotless anchor winches cuff tissue into the bone with a mattress suture that is cinched into place without the need for knots. We reviewed patients who underwent arthroscopic repair with this technique with a minimum follow up of one year. This is prospective study of a consecutive series of the first one hundred patients who underwent arthroscopic cuff repair with the Autocuff system in 2005. Nine were lost to follow-up leaving ninety-one were available for review. All sizes of cuff tear were addressed and in all one hundred and eighty anchors were deployed. There were thirty seven men and sixty seven women with an average age of 69.4 years (range 36–85 years) Follow-up was by clinical assessment, cuff ultrasound and plain radiographs one year after surgery (12–20 months). Pain relief was described as good to excellent in 93% of patients and Constant scores improved by an average of 34 points with 48.5% being good to excellent, 39.4% fair and 12.1% poor. Nine anchors (5%) in eight patients had pulled out at one year, of which three were symptomatic. Suture repair poses varied points of weakness; loose knots, suture attrition and screw toggle all contribute to failure. We have shown that cuff repair by this method appears to be effective up to one year. It is important, however, to spread the tension of the repair with more than one anchor when treating larger tears.

Correspondence should be addressed to The Secretary, British Elbow and Shoulder Society, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE