Rotator Cuff “Bridge” Technique for Large and Irreparable Tears

The Bridge technique uses suture “bridges” to create an anatomically similar and more secure rotator cuff footprint, while establishing a more favorable climate for healing.

Patient Profile:

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

It’s estimated that up to 50% 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, cannot be repaired by conventional techniques of mobilization and soft-tissue releases.  Patients with irreparable rotator cuff tears can present with a wide range of manifestations:  from no symptoms or mild symptoms to those who are completely disabled and suffering extreme pain.   Patients with irreparable rotator cuff tears usually belong to one of two patient groups:  a) older patients, in which minor trauma brings on mild to severe symptoms; or b) younger and more active patients with a history of acute injury or previous rotator cuff problems.

Dr. Karas performs a rotator cuff  “bridge” technique to repair those tendons that are otherwise irreparable via primary repair.  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. 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.