Transosseous cuff repair

Since the 1930s and well until the 1990s, transosseous cuff repair had been the golden standard for the treatment of rotator cuff tear. All this time it had been performed in practically the same way as when it was first introduced by E. A. Codman in 1911. After transition to arthroscopy, transosseal repair had partially receded. Arthroscopic or mini-open repair with suture anchors had mitigated the occurrence of postoperative stiffness and deltoid insufficiency. Unfortunately, it did not yield any major improvement in clinical results.

Based on biomechanical studies and evaluation of results, the suture anchor repair technique is going through gradual evolution. The aim is to replicate the successful original transosseous technique as much as possible. The anchors, however, remain the basic barrier. They are a foreign material, and although they demonstrate great performance in biomechanical studies, they do not allow for full biological healing.

Arthroscopic transosseous technique seems a promising and good solution. It combines the benefits of a simple yet efficient method of fixation of the tendon to the bone with the minimal invasiveness of arthroscopy. This requires an instrument for arthroscopic preparation of tunnels. There have been a number of such instruments over the past 30 years. The most frequently used ones include the American ArthroTunneler and TransOs, as well as the TaylorStitcher from Italy.

The results published so far demonstrate that transosseous cuff repair could be the technique of the future. It achieves a higher footprint coverage and better pressure distribution across the area. The micro-motion on the tendon-bone interface is smaller. Blood circulation in the healing site is much better, and healing is therefore much more natural and biological. Further studies show that postoperative pain recedes earlier. There are none of the potential complications of implants. The terrain is more favourable if revision surgery is required. Cost analyses confirm significant savings in rotator cuff tears treated by transosseous technique.

With our Drillbone Tunneler, transosseous cuff repair is a very simple operation. We build on those who didn’t give up and continued developing these instruments for the past 30 years. Drillbone Tunneler is a tool based on an entirely new principle and you will enjoy using it. We would like to contribute to the evolution of rotator cuff repair. In many aspects, transosseous cuff repair meets the principles of value-based care. It delivers a value to the patients, surgeons, as well as to medical care payers.

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