Dual-Row Bridge Technique Rotator Cuff Repair

It's estimated that up to 50 percent of adults over 50 years of age have some degree of rotator cuff tearing. Irreparable tears are those that, because of their size and retraction, cannotbe repaired by conventional techniques of mobilization and soft-tissuereleases.

Rotator cuff tears can present themselves with a wide range of manifestations: from no symptoms or mildsymptoms, to completely disabling, and the source of extreme pain.

Patients with irreparable rotator cuff tears usually belong to one of two patient groups:

  • Older patients, in which minor trauma brings on mild to severe symptoms; or
  • Younger and more active patients with a history of acute injury or previous rotator cuff problems. How does rotator cuff "bridge" technique help?

The rotator cuff "bridge" technique uses suture "bridges" to create an anatomically similar and more secure rotator cuff footprint, while establishing a more favorable climate for healing. Emory Sports Medicine performs this technique to repair those tendons that are otherwise irreparable. This "bridge" technique utilizes an allograft dermal matrix - a portion of donated human dermis that is processed and preserved for surgical augmentation of deficient tissues.

Patients who undergo this surgery include those who have:

  • Complete ruptures of at least two rotator cuff tendons
  • Irreparable rotator cuff tears
  • Pain and weakness, with full shoulder range of motion

The bridge matrix accomplishes numerous goals. First, the graft allows for a tension-free repair, which increases the chances of tendon healing. Second, the tendon bridge allows for improved contact area and mean footprint pressure, because the graft is trimmed to fit the individual tear size and configuration. Finally, the graft reestablishes the anatomic continuity and biomechanical function of the rotator cuff, thus eliminating pain, improving function, and potentially slowing the progression of arthritis in the glenohumeral joint.