Question:I went to the orthopedic surgeon for a torn rotator cuff. She talked a lot about "fixation" methods in surgery. I didn't really understand this idea. What is that?
The surgeon's job is to reattach the torn tendon but needs some way to hold it in place while it heals. This can be done in a number of different ways and is called tendon fixation. For a rotator cuff repair, the sutures may be placed at the tip or end of the bone or tied over a wider bone bridge.
Sometimes the surgeon uses what's called an anchor suture. This is a stitch that connects the end of the tendon to the bone. They can also use a button anchor. The suture goes through the button to give greater strength to the repair. These are used especially when the bone is weak from osteoporosis.
A third option is called a transosseous suture. A tunnel is drilled through the bone from one side to the other. The suture is threaded through the canal. A recent study at Columbia University showed that this method gives a much tighter "fixation" and is less likely to fail.
Don't hesitate to ask your surgeon to show you a drawing or picture of the operation planned. The more you understand about what's being done the better able you may be to follow the planned rehab and avoid movements and positions that might compromise the healing tissue.Christopher S. Ahmad, MD et al. Tendon-Bone Interface Motion in Transosseous Suture and Suture Anchor Rotator Cuff Repair Techniques. In The American Journal of Sports Medicine. November 2005. Vol. 33. No. 11. Pp. 1667-1672.
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