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Rotator Cuff Reconstruction with an Autologous Hamstring Tendon Patch (TEAR Patch)

February 10, 2018

Contributors: Joern Kircher, MD; Joern Kircher, MD

The video demonstrates reconstruction of a large supraspinatus tendon defect in a 59-year-old woman in whom arthroscopic rotator cuff repair failed. A tendon patch consisting of autologous hamstring tendon from the knee is used to cover the tendon defect. The TEAR patch is created by dividing one of the cleaned hamstring tendons into two parts, resulting in two strands of tendon that are used to weave the TEAR patch. Both strands are woven into each other on a rectangular frame, resulting in a woven patch made of hamstring tendon with intrinsic stability. Rotator cuff reconstruction is performed via a mini-open approach; however, arthroscopic placement is possible. The TEAR patch is fixed to the rotator cuff remnants with the use of a suturing device and nonabsorbable sutures. The lateral edge of the patch is fixed to the rotator cuff footprint at the major tubercle with the use of two double-loaded titanium suture anchors. Final dynamic testing of the implanted patch shows complete anatomic reconstruction of the defect, perfect alignment, and strong fixation. Postoperative imaging obtained 6 months after reconstruction demonstrates an intact tendon patch with a centered glenohumeral joint. The patient is pain free, has resumed activities of daily living, and has returned to office work.

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