Shoulder Arthroscopy Rotator Cuff Repair
Silver Handle Instruments x 2 are the 20° & 45° elevators
Red Handle Instrument is the double sided Glenoid Rasp
Yellow Handle Instrument is the Arthrex 8.25mm Cannula Insertion Handle (to be used along with a switching stick or wissenger rod)
Orange Handle Instrument is the Arthrex 5.75mm Crystal Cannula Insertion Handle (also to be used with a switching stick or wissinger rod, located in the handle on the left side of my pan)
Purple Handle Instrument is the Arthrex 3.0 Bio-Suture Tak Anchor Handle (for labral repairs). This handle has a sharp & blunt obturator, as well as a drill bit (located in the handle on the left side of my pan)
1st Green Handle is the Tap for the 4.5 Bio-Corkscrew Anchor (for Rotator Cuff repairs)
2nd Green Handle is the Punch for the Arthrex 4.5 Bio-Corkscrew & the Arthrex 4.75 SwivelLock Anchors
Arthrex Graspers :
– Suture Retriever
– Cuff Grasper
– King Fisher
– 15° Bird Beak
– 40° Bird Beak
– Suture Cutter w/ tail
– Suture Cutter flush cut (no tail)
More & Less Angled Elevators
Used to tease free the Labrum before reattachment to the Glenoid
Rotator Cuff Surgery
If there is an underside tear in the cuff (intra articular) yet on the bursal side (sub acromial) there is still some continuity of tissue (yet lacking any real strength), the Dr. may use this instrument to tease the flimsy tissue apart before inserting the anchor & doing the cuff repair
May be used on the distal part of the dissection when the Dr. wants to tease the tissue away from the axillary nerve before arthrowanding it.
Glenoid Rasp used to prep the bone prior to anchor placement. Roughed up bleeding bone will help the tkissue to re-adhere to the bone. The glenoid in labral repairs & the humeral head in Rotator cuff repairs.
Instrumentation for Arthrex 3.0 Bio-Corkscrew Anchor for Labral Repair
Top to Bottom
– Purple Inserter Handle
– Blunt Obturator goes into handle & obstructs irrigation from flowing out during placement of the handle (this is the one we use)
– Sharp Obturator for Inserter Handle same as blunt obturator (we do not use the sharp obturator it just came with the handle as a set)
– Drill Bit gets chucked up on a Jacobs Chuck on a cordless mini driver. Drill bit has a laser line at the tip to lrt thr Dr know that the corrwct depth has been drilled as well as having a positive stop on the back end of the drill bit.
4.5 Punch for the Arthrex 4.5 Bio-Corkscrew & 4.75 SwivelLock Anchors
At the tip there are 2 laser etched lines:
– 1st line (most distal) is for the 4.5 Bio-Corkscrew
– 2nd line (more proximal) is gor the 4.75 SwivelLock
Tip*** When doing the lateral row (4.75 SwivelLock) color the laser lines with your marking pen to create a ring on the bone to make it easier for the Dr. to find his hole when inserting the anchor.
4.5 Tap for the Arthrex 4.5 Bio-Corkscrew Anchor for Rotator Cuff Repair
Gets malleted into the bone to the 2nd thread the screwed in & out. A tap cuts threads for a screw to follow.
Knot Pusher, knots are made externally and then, pushed through the cannula to cinch down the soft tissue (cuff or labrum) back to the bone.
From Top to Bottom
– Obturator for 8.25mm Cannula
– 8.25 Cannula
– Yellow Metal Cannula Handle for 8.25 Cannula
– Orange Metal Cannula Handle for 5.75 Cannula
– Switching Stick
– Wissinger Rod
8.25mm Cannula Assembly put together w/ Wissinger Rod (switching stick may be used instead of the wissinger rod).
Penetrator used in Rotator Cuff Repairs to pierce through the Rotator Cuff & pick up the suture that is anchored into the humeral head.
20° & 40° Bird Beaks used in Labral Repairs to pierce through the labrum pick up suture that is anchored into the Glenoid, the pull it through.
Suture Cutters, see description on next photo below.
– Tails Cutter (left side) when cuttin sutures this instrument leaves a 2mm tail. This is used in Labral Repairs, Side to Side Cuff Repairs, Single Row Cuff Repairs. Basically anywhere there is a
knot you will use the 2mm tails cutter
– Flush Cutter (No Tails Cutter)(right side) when cutting sutures this instrument leaves NO tails. This is used in lateral row repairs where no knot is necessary (so the suture is cut flush to the
anchor & bone. This is also used in knotless repairs such as the Speed Bridge Technique.
Suture Retriever, used to grasp & retrieve sutures.
Rotator Cuff Grasper, used to grasp the cuff to aid in mobilization before the repair.
King Fisher, this instrument is a combination of the Rotator Cuff Grasper & Suture Retriever. The narrow tip dialates throught tissue easily, the center is open to retrieve sutures, the tip has grasping teeth same as the Rotator Cuff Grasper.
Arthrex 4.5mm Bio-Corkscrew Anchor for Rotator Cuff Repair, if doing a double row repair this will be used for the medial row (initial fixation of the Rotator Cuff to the Humeral Head). The anchor will be placed in the Humeral Head, sutures from the anchor will pass through the cuff, then the sutures will be tied down. If doing a single row repair the sutures will then be cut, however if doing a double row repair the strands of the tied sutures will NOT be cut, instead the strands will be fed into the 4.75mm SwivelLock Anchor & anchored laterally on the humeral head.
Arthrex 4.75mm Bio-SwivelLock Anchor
– If doing a single row knotless repair, Fibertape is passed through the Rotator Cuff, then fed into the SwivelLock Anchor & fixated into the Humeral Head (Speed Bridge Technique)
– If doing a double row repair this will be used for the lateral row (secondary fixation of the Rotator Cuff to the Humeral Head). The medial row anchor anchor will be placed in the Humeral Head, sutures from the anchor will pass through the cuff, then the sutures will be tied down. The strands of the tied sutures will NOT be cut, instead the strands will be fed into the 4.75mm SwivelLock Anchor & anchored laterally on the humeral head.