Arrigoni Paolo, Brady Paul C, Burkhart Stephen S
The San Antonio Orthopaedic Group, San Antonio, Texas, USA.
Arthroscopy. 2007 Jun;23(6):675.e1-4. doi: 10.1016/j.arthro.2006.08.016. Epub 2007 Jan 5.
In an effort to maximize the area of footprint coverage, we developed the "double-pulley technique" for double-row rotator cuff repairs. Two suture anchors are inserted at the articular margin of the greater tuberosity (one anterior and one posterior). All 4 suture strands from each anchor are passed through a single medial point on the torn cuff. In this way, the 4 suture strands from the anteromedial anchor pass through 1 point in the cuff and the 4 strands from the posteromedial anchor pass through a different point in the cuff. A suture strand from 1 anchor is tied extracorporeally to a suture strand of the same color from the other anchor. The other ends of those 2 strands are then pulled, thereby delivering this extracorporeal knot into the joint and over the medial footprint. These 2 free suture strands are then tied together as a static knot. The procedure is repeated with the other sutures. This technique creates a double mattress suture medially, which compresses the intervening tendon bridge against its bone bed. We call this procedure the double-pulley technique because it uses the anchor eyelets as pulleys to deliver the extracorporeal knot into the shoulder. After the lateral row repair is performed, the rotator cuff footprint will be completely reconstituted.
为了最大限度地扩大足迹覆盖面积，我们开发了用于双排肩袖修复的“双滑轮技术”。在大结节的关节边缘插入两个缝合锚钉（一个在前，一个在后）。每个锚钉的所有4根缝线都穿过撕裂肩袖上的一个单一内侧点。通过这种方式，前内侧锚钉的4根缝线穿过肩袖上的1个点，后内侧锚钉的4根缝线穿过肩袖上的另一个不同点。将一个锚钉的一根缝线在体外与另一个锚钉相同颜色的一根缝线打结。然后拉动这2根线的另一端，从而将这个体外结送入关节并越过内侧足迹。然后将这2根游离缝线作为一个固定结系在一起。对其他缝线重复该操作。该技术在内侧形成一个双褥式缝线，将中间的肌腱桥压在其骨床上。我们将此操作称为双滑轮技术，因为它使用锚钉孔作为滑轮将体外结送入肩部。在进行外侧排修复后，肩袖足迹将完全重建。
