Mini Open Rotator Cuff Repair Delhi By Dr Shekhar Shrivastav

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Mini Open Rotator Cuff Repair in Delhi,Mini Open Rotator Cuff Repair, By Dr Shekhar Shrivastav - Dr. Shekhar Srivastav is an Orthopedic Surgeon attached to Sant Parmanand Hospital, Delhi with special interest in Knee & Shoulder surgery. After obtaining his M.S. Orthopedics degree he has undergone training in various centers in India and Abroad which has helped him in understanding the Orthopedics problems and their Management. He did his AO/ ASIF fellowship at University Hospital, Salzburg, Austria in 2006 and recieved training in Arthroscopy & Sports Medicine at TUM, Munich (Germany) & Rush Orthopedics Centre, Chicago( USA). He has an experience of more than fifteen years of diagnosing and treating Orthopedics & Trauma patients.

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Mini Open Rotator Cuff Repair Delhi By Dr Shekhar Shrivastav

  1. 1. MINI OPEN ROTATOR CUFF REPAIR- TIPS DR SHEKHAR SRIVASTAV Sr Consultant- Knee & Shoulder Arthroscopy Sant Parmanand Hospital,Delhi
  2. 2. Rotator Cuff Repair Open Repair Mini-open repair Arthroscopic assisted Miniopen Repair Arthroscopic Repair 
  3. 3. Mini Open Advantage Can be done by non-arthroscopic Orthopedic surgeon Transosseous fixation- stronger and better healing potential. Long term results comparable to Arthroscopic fixation 
  4. 4. Full Thickness RC tear
  5. 5. Mini Open Rotator Cuff Repair Approach Rotator Cuff Mobilisation & Repair Sub-Acromial Decompression Post-op Rehab 
  6. 6. Approach Positioning Beach Chair/ Lateral Skin Markings Skin Incision Deltoid split 
  7. 7. Positioning  Lateral with traction
  8. 8. Planning & Skin Markings L P A H
  9. 9. Skin Incision L POST ANT H
  10. 10. Deltoid Split
  11. 11. Deltoid Split
  12. 12. Bursa Excision
  13. 13. Bursa Excision
  14. 14. Rotator Cuff Identification Anatomy Mobilisation & Excursion Footprint Preparation Rotator Cuff Fixation 
  15. 15. Cuff Identification BURSA CUFF
  16. 16. Cuff Identification
  17. 17. Holding Sutures
  18. 18. Holding Sutures HH
  19. 19. Rotator Cuff Mobilisation  sn
  20. 20. Holding Sutures
  21. 21. Humeral Footprint
  22. 22. Rotator Cuff Fixation  dd
  23. 23. Rotator Cuff Fixation  rt
  24. 24. Anchors
  25. 25. Cuff Bite
  26. 26. Cuff Bite
  27. 27. Tightening Sutures
  28. 28. Completed Repair
  29. 29. RC Repair  s
  30. 30. Repaired cuff
  31. 31.  e
  32. 32. Sub-Acromial Decompression  s
  33. 33. Sub-Acromial Decompression
  34. 34. Mini-Open Problems Difficult access and Visualisation  Inability to address intraarticular problems  Trauma to Deltoid  More pain in post-op & early recovery period  Post-op stiffness 
  35. 35. Take Home Message Mini-open repair can give as good result as an arthroscopic repair  Approach-Aware of the position of Axillary N.  Understand the anatomy of the Cuff tear  Mobilise cuff properly so that the cuff is not fixed in too much of tension  Use of arthroscopic instruments- very helpful  Can give better result if combined with diagnostic arthroscopy and management of intra-articular problems 
  36. 36. Thank You

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