Arthroscopic Transosseous Rotator Cuff Repair PDF
Preview Arthroscopic Transosseous Rotator Cuff Repair
Arthroscopic Transosseous Rotator Cuff Repair Tips and Tricks Claudio Chillemi Alessandro Castagna Marcello Osimani 123 Arthroscopic Transosseous Rotator Cuff Repair Claudio Chillemi • Alessandro Castagna Marcello Osimani Arthroscopic Transosseous Rotator Cuff Repair Tips and Tricks Claudio Chillemi Alessandro Castagna Department of Orthopaedics Shoulder Unit and Traumatology Istituto Clinico Humanitas Istituto Chirurgico Ortopedico Milan Traumatologico (ICOT) Italy Latina Italy Marcello Osimani Department of Radiological Sciences, Oncology and Pathology “Sapienza” - University of Rome (ICOT Latina) Rome Italy ISBN 978-3-319-76152-7 ISBN 978-3-319-76153-4 (eBook) https://doi.org/10.1007/978-3-319-76153-4 Library of Congress Control Number: 2018941560 © Springer International Publishing AG, part of Springer Nature 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by the registered company Springer International Publishing AG part of Springer Nature. The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland To my father who passed away too soon, to my beloved wife Sabrina who has always supported me, and my lovely kids Carlo and Irene Claudio Chillemi Foreword Orthopedics and general surgery are, first and foremost, biology. Claudio Chillemi is a highly trained physician, an avid researcher, and a skilled surgeon. I consider him to be my star pupil and one of my best friends. Thus, it is a great honor to be invited to write the preface for “Arthroscopic Transosseous Rotator Cuff Repair: Tips and Tricks”. Rotator cuff pathology is one of the most common shoulder problems. The area of insertion of the tendon into the bone is universally called enthesis (from the ancient Greek ἔνθεσις, meaning “to put in; insertion”). This is a critical zone in pathogenesis and a challenge in the surgical repair of rotator cuff lesions. Therefore, the editor is com- mended on selecting this critical and frequently neglected aspect of rotator cuff biology and repair. The texbook is composed of 14 chapters that provide a comprehensive view of the anatomy, pathophysiology, classification, imaging, and treatment of the rotator cuff. The treatment section of this text begins with a description of common surgical techniques and extends into more complex material, incorporating new and original transosseous arthroscopic rotator cuff repair approaches. The traditional methods of treatment are thus revisited in a modern way. These techniques can reduce pain, improve functional move- ment, and provide additional time before arthroplasty is required. The described techniques are especially useful for treating elderly osteoporotic patients who experience massive ruptures or reruptures. Each chapter in this book benefits from the strong contributions of the edi- tor, Claudio Chillemi. The technical tips and tricks for the surgical proce- dures are well described. Furthermore, great attention was placed on the biological and biomechanical aspects of enthesis anatomy and repair. The text is supplemented by superb illustrations and photographs, which elucidate the surgical techniques proposed. The book is completed by a comprehensive list of relevant references. vii viii Foreword This contribution to the literature provides important and new information that will be of interest to both students of shoulder pathology and experts in the field. Claudio Chillemi deserves to be congratulated for this valuable addition to the shoulder literature. He is a great friend to me—and to all who embrace this textbook. Ancona, Italy Antonio P. Gigante Foreword I believe that every aspect of our profes- sional lives should be permeated by true passion. Only when passion meets intel- lect and capabilities can we reach greatness. When I started in the medical field, I was looking for a mentor. In my mind, a mentor is not only confident about his or her abilities but is also willing to share knowledge and experience, with the patience to support new initiatives and failed attempts. Thus, I considered myself privileged to meet Alex Castagna. I imme- diately recognized his superiority and greatness—not only because he was tal- ented and admired worldwide in his field, but also because he enjoyed work- ing and teaching. I had the same feeling when I met Claudio Chillemi the first time. Claudio clearly displayed talent and amazing surgical skills, but he also had the ideal combination of dedication and passion in his job. I met Marcello Osimani only once in my life, during a visit to the hospital in Latina at 10 pm. On that occasion, he was so excited to share with me the results of his work. Right away, I realized he is the perfect completion to this group of brave individuals, who were willing to invest their free evenings and weekends to write this book. Working hard can be easy when you are sur- rounded by the right people in a sincerely impassioned environment. When you add friendship to this mix, what you get is simply magic. The common drivers in this scenario are curiosity and an ambition for perfection, as part of an endless and constant exercise toward improvement. When I started researching the transosseous technique, I immediately felt the need for updated supporting literature in order to clarify the unknown aspects and preconceptions in this field. My need was met by this monumen- tal work. The huge collection of data contained in this book is impressive and remarkable, showing the common characteristics of the authors: curiosity, passion, hard work, dedication, and talent. This book covers all aspects of the transossoeus approach, starting from a foundation of biological science and progressing through postoperative reha- bilitation. Along the way, the chapters discuss biomechanical factors and ix x Foreword technologies in the marketplace, tracing the evolution over time, proposing solutions, and offering a view on the future. All of the material is supported by an impressive reference collection, which provides infinite possibilities to deepen one’s knowledge on the subject. The content of this book is the result of extensive research made possible only by the complete dedication of the authors. This text serves as proof of their intellectual interest in the shoulder, as well as their tireless and continu- ous attempts to improve not only their capabilities but also their contributions to the collective knowledge in the field. Matteo Mantovani Technical Director - CEO, NCS Lab, Carpi (MO) Italy Foreword More than 35 years ago, I had the pleasure of meeting, mentoring, collaborating with, and enjoying a lifelong friendship with Alessandro (“Alex”) Castagna. It did not take long after that first meeting to understand that he was a special person— a remarkable surgeon who possesses a superior creative intellect. People like Alex are exceptional. As any of his students, fellows, or co-w orkers will agree, he is the combination of a per- fect gentleman, a brilliant scholar, and a generous teacher. He led the development of the orthopedic program at Humanitas Hospital in Milano and worked with his revered professor, Mario Randelli, to create an international institute of orthopedic higher education. Dott. Castagna has led the Italian and European Societies of Arthroscopy, as well as Shoulder and Elbow Surgery, as the president. He is active in Italian, European, Asian, and American societies and organized many workshops, symposiums, and educational courses, which are too numerous to mention. Not only is Alex devoted to sharing his knowledge with the world of shoulder students, but he also has a desire to improve the outcomes of shoulder surgery. He was the first surgeon to enlighten me about the critical role of biologics in nature’s scheme of rotator cuff healing. He and his co- authors have a background in physiology as well as surgery. Thus, they have studied the benefits of maximizing the implantation environment, incorporat- ing nature’s recipe for the ideal debridement of the cuff edge (to eliminate noxious metalloproteinase substances), and stimulating the body’s growth factors and mesenchymal stem cells to enhance healing. This rich and dynamic background fostered Dott. Castagna’s realization that there is a need to improve the arthroscopic methods we currently use to repair a damaged rotator cuff tendon to bone. By employing a simple transos- seous method that uses a special 2-mm-thick needle fabricated from super- elastic Nitinol (dubbed the “Taylor Stitcher”), Alex and his team of engineers at NCS Lab have developed an ingenious system to rapidly and safely repair the torn tendon to bone. By eliminating the need for permanent metal or plas- tic implants, the NCS Taylor Stitcher will revolutionize rotator cuff surgery xi
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