Clin Orthop Surg.  2012 Sep;4(3):242-245. 10.4055/cios.2012.4.3.242.

Modified Mason-Allen Suture Bridge Technique: A New Suture Bridge Technique with Improved Tissue Holding by the Modified Mason-Allen Stitch

• Lee BG
• Cho NS
• Rhee YG

• KMID: 1392988
• DOI: http://doi.org/10.4055/cios.2012.4.3.242

Abstract

We present a new method of suture bridge technique for medial row fixation using a modified Mason-Allen stitch instead of a horizontal mattress. Medial row configuration of the technique is composed of the simple stitch limb and the modified Mason-Allen stitch limb. The limbs are passed through the tendon by a shuttle relay. The simple stitch limb passes the cuff once and the modified Mason-Allen stitch limb passes three times which creates a rip stop that prevents tendon pull-out. In addition, the Mason-Allen suture bridge configuration is basically a knotless technique which has an advantage of reducing a possibility of strangulation of the rotator cuff tendon, impingement or irritation that may be caused by knot.

Keyword

Rotator cuff; Arthroscopic repair; Suture bridge technique; Modified Mason-Allen stitch; Tissue holding

MeSH Terms

Arthroscopy/methods
Humans
Rotator Cuff/injuries/*surgery
Suture Anchors
*Suture Techniques

Figure

• 

  Fig. 1 (A) The 1st tendon passage, (B) the 2nd tendon passage in a Mason-Allen stitch and formation of horizontal loop.

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  Fig. 2 (A) The 3rd tendon passage in a Mason-Allen stitch. (B) The simple stitch limb passes the tendon just medial to horizontal loop which acts as a rip-stop.

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  Fig. 3 Final configuration of a Mason-Allen suture bridge repair.

Reference

1. Accousti KJ, Flatow EL. Technical pearls on how to maximize healing of the rotator cuff. Instr Course Lect. 2007. 56:3–12.

2. Toussaint B, Schnaser E, Lafosse L, Bahurel J, Gobezie R. A new approach to improving the tissue grip of the medial-row repair in the suture-bridge technique: the "modified lasso-loop stitch". Arthroscopy. 2009. 25(6):691–695.

3. Demirhan M, Atalar AC, Kilicoglu O. Primary fixation strength of rotator cuff repair techniques: a comparative study. Arthroscopy. 2003. 19(6):572–576.

4. Gerber C, Schneeberger AG, Beck M, Schlegel U. Mechanical strength of repairs of the rotator cuff. J Bone Joint Surg Br. 1994. 76(3):371–380.

5. Rhee YG, Vishvanathan T, Thailoo BK, Rojpornpradit T, Lim CT. The '3 sister portals' for arthroscopic repair of massive rotator cuff tears. Tech Shoulder Elbow Surg. 2007. 8(2):53–57.

6. Ma CB, MacGillivray JD, Clabeaux J, Lee S, Otis JC. Biomechanical evaluation of arthroscopic rotator cuff stitches. J Bone Joint Surg Am. 2004. 86(6):1211–1216.

7. Park MC, Elattrache NS, Ahmad CS, Tibone JE. "Transosseous-equivalent" rotator cuff repair technique. Arthroscopy. 2006. 22(12):1360.e1–1360.e5.

8. Park MC, Tibone JE, ElAttrache NS, Ahmad CS, Jun BJ, Lee TQ. Part II: Biomechanical assessment for a footprint-restoring transosseous-equivalent rotator cuff repair technique compared with a double-row repair technique. J Shoulder Elbow Surg. 2007. 16(4):469–476.

9. Cummins CA, Murrell GA. Mode of failure for rotator cuff repair with suture anchors identified at revision surgery. J Shoulder Elbow Surg. 2003. 12(2):128–133.

10. Barmakian JT, Lin H, Green SM, Posner MA, Casar RS. Comparison of a suture technique with the modified Kessler method: resistance to gap formation. J Hand Surg Am. 1994. 19(5):777–781.