Arthroscopic modified trans-osseous rotator cuff repair using the giant needle technique and racking hitch knot

Abstract

Abstract Purpose This study analyzed the midterm functional outcomes of arthroscopic trans-osseous (TO) rotator cuff repair using special needles called giant needles. The aim of revisiting and modifying a previously described technique is to facilitate the passage of the giant needle, making it easier, and more reliable. We also enhanced the repair construct by passing the sutures through the tendon in a separate step and applying a strong racking hitch knot. Methods Sixty-two patients (41 females and 21 males with a mean age of 55.16 years) underwent arthroscopic TO rotator cuff repair for symptomatic full-thickness tears. Pre- and post-operative pain severity, the Constant Shoulder (CS) score of the affected shoulders and the subjective value of the shoulders (SSV) were recorded. Patients were followed up at 3, 6, 12, and 24 months after surgery. Results The mean pain severity improved from 8.61 preoperatively to 1.73 after two years of surgery. Similarly, the mean preoperative CS score and SSV improved from 41.29 to 88.72 and from 42.85–92.15%, respectively. We recorded two cases with postoperative stiffness and two other cases underwent arthroscopic revision of rotator repair due to traumatic cuff re-tears. Conclusion The trans-osseous modified technique with giant needle is a reliable, and safe technique yielding satisfactory midterm outcome scores. This technique combines the minimal invasive advantage of arthroscopic procedures with the cost-effectiveness and biomechanical advantages of the open TO procedures. Further comparative studies are recommended to support our results.