Treating massive rotator
cuff tears and revisions

Problem: Massive tears have
the highest failure rates

Many surgeons and their patients would prefer rotator cuff repair over joint replacement. Even with advances in rotator cuff repair techniques and technology in recent years, tissue quality, biomechanical forces and lack of a good vascular supply1,2,3,4 have led to reported failure rates of as high as 68%1 in large to massive tears (Grades III and IV).

 

 

However, surgeons who use a biologic scaffold and innovative anchors like the Y-Knot RC are achieving higher success rates while still preserving the joint.2,4

 

 

 

SURGEON PRESENTATION VIDEOS

“For massive or revision rotator cuff tears, the patient has the best chance with a low-tension repair and an acellular human dermal matrix allograft.” 

- Stephen Snyder, MD
Southern California Orthopedic Institute
Paid CONMED Consultant

Solution: Augment the Repair with an
Extracellular Matrix (ECM) scaffold

In large tears and revisions, poor tissue quality is one the biggest obstacles to performing a successful repair.

By augmenting the tissue with an ECM scaffold like Allopatch HD®, peer reviewed research has shown that surgeons can potentially go from a 40%2 success rate without augmentation to an 85.7%4 success rate with augmentation.

 

A Stronger Scaffold Option than Synthetics
and Xenografts

Among the available scaffold types, clinical studies have shown that ECMs like Allopatch HD® are stronger – exhibiting better suture retention and greater ultimate load failure rates than synthetics and xenografts.3


Solution: Take the Uncertainty Out of Choosing
the right ECM with Allopatch HD®

No Prep Time Required

Unlike other ECMs that need to be hydrated for 60 minutes or longer before being used – delaying completion of the procedure and prolonging OR time – Allopatch HD® requires no refrigeration or rehydration and it is ready to use off the shelf almost immediately.

 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Minimally Processed

Allopatch HD® is minimally processed and not crosslinked which better preserves and maintains the graft’s natural biomechanical, biochemical and matrix properties.

Tissue Quality – Not all Allografts are the Same

While it is often assumed that all allograft tissue is the same, tissue quality can actually vary greatly depending on the standards of the tissue bank. Musculoskeletal Transplant Foundation (MTF), the tissue bank that supplies ConMed the allograft tissue, has some of the most stringent donor selection standards of any tissue bank in the world, which allows MTF to process aspetically, thus preserving the tissues natural biomechanical and biochemical properties.


Allopatch HD®

“For all large, recurrent, or irreparable rotator cuff tears that require grafting, I use MTF grafts. They have very high donor selection standards and the grafts have been the most reliable of any grafts I have used in terms of their thickness, consistency, and healing. I know that the tissue I’m using is both safe and high quality.” 

- Joseph Burns, MD
Southern California Orthopedic Institute
Paid CONMED Consultant
SURGICAL TECHNIQUE ANIMATIONS

Solution:
Choose the right anchors for the right procedure

All-Suture:
Y-Knot® RC Self-Punching All-Suture Anchors

To help simplify the technique, the self-punching Y-Knot® RC anchors provide strong purchase in bone with a smaller footprint than traditional fixation methods.

With a 2.8mm size that’s available double or triple loaded, Y-Knot RC anchors require less bone removal than larger metal, PEEK and biocomposite anchors – improving placement options when bone real estate is limited or if the original anchors remain intact from a failed repair.

 



The combination of small size, high pullout strength and simple technique make the Y-Knot RC the ideal anchor for massive rotator cuff tears.

Y-Knot RC®

PEEK/Biocomposite:
CrossFT Fully-Threaded Anchors

CrossFT fully threaded suture anchors are available in PEEK or our proprietary GENESYS™ biocomposite material and provide the combination of strength and bone in-growth5 seldom found in other anchors.

 The cortical and cancellous threads provide industry leading pullout strength of 689N6. The anchor’s




cannulation may channel growth factors to the healing tendon. These anchors are also available with swaged on needles for a mini-open technique.

CrossFt

Double-Row Repairs:
PopLok Knotless Anchors

For surgeons who perform double-row repairs or fixate the Allopatch HD® laterally, the PopLok® Knotless Suture Anchors feature a suture locking mechanism that traps suture within

 




the anchor for dependable fixation and also provides the ability to tension the suture after the anchor is seated in the pilot hole.

PopLok®

“These are reliable and strong anchors that work very well in all my patients.” 

- Jeffrey Abrams, MD
Princeton Orthopaedic Associates
Paid CONMED Consultant

Eliminator PET Balloon Dilator Wall Chart

1Jost B, Pfirrmann CWA, Gerber C. Clinical outcome after structural failure of rotator cuff repairs. J Bone Joint Surg Am 2000; 82:304-14.) 2Barber FA, Burns JP, Deutsch A, Labbé MR, Litchfield RB.. A prospective, randomized evaluation of acellular human dermal matrix augmentation for arthroscopic rotator cuff repair. Arthroscopy. 2012 Jan;28(1):8-15. doi: 10.1016/j.arthro.2011.06.038. Epub 2011 Oct 5. 3Barber, FA, Aziz-Jacobo J. Biomechanical testing of commercially available soft-tissue augmentation materials. Arthroscopy
2009;25:1233-1239. 4Agrawal, V. Healing rates for challenging rotator cuff tears utilizing an acellular human dermal reinforcement graft.Int J Shoulder Surg. 2012 Apr;6(2):36-44. doi: 10.4103/0973-6042.96992. 5Daculsi G, et al., Osteoconductive properties of poly(96L/4D-lactide)/beta-tricalcium phosphate in long term animal model, Biomaterials 2011, doi:10.1016/j.biomaterials.2011.01.033. 6Barber FA, et al., Cyclic Loading Biomechanical Analysis of the Pullout Strengths of Rotator Cuff and Glenoid Anchors: 2013 Update, Arthroscopy 2013; 29:832-844. 7 Data on File TR16-787. 8 Data on file. TR16-219.