“With Tensor we’re not limited by anchor configuration, you have more ability to add points of fixation for the same amount of exposed tuberosity. We’re not limited by having a one centimeter bridge between anchors or the number of sutures within an anchor. With Tensor you can come up with any configuration you want.”
“Arthroscopic transosseous rotator cuff repair using the Tensor Surgical device is the least painful method of rotator cuff repair I have used. This is often reported back to me by therapists who perform postop rehab them and compare results with other surgical patients. The reason for the pain reduction is simple – transosseous tunnels created with the Tensor device vent the humeral bone and reduce the pressure within the humeral head. Anchors increase the pressure in the humeral head. Additionally, the tunnels allow for humeral bone marrow and mesenchymal stem cells to flow right into the rotator cuff repair site. Anchors plug the hole and don’t allow that biologic boost. This is just a tremendous advantage for Tensor.”
Dr. Uma Srikumaran discusses his research comparing an anchored rotator cuff repair with an anchorless or transosseous approach. This is a cohort analysis comparing clinical and patient reported outcomes, structural integrity and costs.
- Dr. Srikumaran is an associate professor of orthopaedic surgery at the Johns Hopkins School of Medicine and chair of the Department of Orthopaedics at Howard County General Hospital, specializing in fracture fixation, rotator cuff repair, shoulder stability procedures, revision shoulder surgery, and shoulder replacement.
- Dr. Srikumaran earned his M.D. from the Johns Hopkins School of Medicine and completed his residency in orthopaedic surgery at The Johns Hopkins Hospital. His fellowship in shoulder and elbow surgery was at Harvard at Massachusetts General Hospital and Brigham and Women’s Hospital in Boston, MA. He joined the Johns Hopkins in 2011 and focuses on research in clinical outcomes and value analysis.
“During my fellowship, I trained under Dr Sumant Krishnan, who developed the ArthoTunneler arthroscopic transosseous tunneling device.
I had the benefit of watching him perform hundreds of rotator cuff repair surgeries and truly understanding the benefits of transosseous rotator cuff repair, including
1.) Ability to create any type of repair configuration,
2.) A more anatomic re-creation of the repair site, and
3.) Significant cost savings compared to anchor-based repair.
Not only is the Tensor System even more cost efficient than the ArthroTunneler, it has fewer steps, is more accurate and creates a larger footprint for repair.
It is my belief that, in this value driven healthcare environment, using the Tensor TransOs Tunneler for rotator cuff repair will become the gold standard.
Compared to anchor-based rotator cuff repair, the Tensor System is just as clinically effective and allows one to place sutures in any type of repair configuration at a significant cost savings.”
• Dr. Paterson is a shoulder specialist, practicing in Gilbert, Arizona as part of OrthoArizona Complete Musculoskeletal Care (Orthoarizona.org).
• Dr. Paterson earned his medical degree from the Rosalind Franklin University of Medicine and Science in Chicago, IL, and completed his residency at the Campbell Clinic in Memphis, TN. He did his fellowship training in disorders of the shoulder under two of the world’s leading experts at Baylor University Medical Center / The Carrell Clinic Shoulder Service in Dallas, TX.
“I have been using true transosseous tunneled fixation for 90% of my arthroscopic rotator cuff repairs for 7 years, both in hospital and in ambulatory surgery center.
Tunneling has value in the revision setting requiring working around existing anchors or large cystic defects at the articular margin or laterally on the greater tuberosity from previous anchors.
Post-operative pain seems to be substantially lower in tunneled repair versus anchored repair.
The Tensor Tunneler is straight forward and easy to use, but the dramatic difference is the predictability of capture of the shuttling suture in the tunneler.
This reproducibility has improved my overall case efficiency.
Further, the cost of the passing needle is far less than the system I used previously and has delivered increased case reimbursements at the ambulatory surgery center.”
- Dr. Johnston is a shoulder specialist at Southern Maryland Orthopaedics & Sports Medicine Center. He completed his medical degree at Wayne State University in Detroit, MI, his orthopaedic residency at Wayne State University and University of North Carolina, Chapel Hill, NC. His fellowship was at the Rothman Institute, Thomas Jefferson University, Philadelphia, PA, specializing in shoulder and elbow surgery. While there, he focused on joint replacement for arthritis, instability, fractures, rotator cuff and labral tears, and triceps and biceps tendon tears.
- Dr. Johnston research interests include numerous peer-reviewed publications and is focused on implant design and novel bearing surfaces for shoulder replacement, pain management after shoulder surgery, and understanding failures of previous techniques in rotator cuff repair.
“Transosseous rotator cuff repair shows biological and biomechanical advantages in rotator cuff repair and it’s possible to perform it arthroscopically with a simple technique that allows us to create all cuff repair configuration avoiding anchor complications.
The Tensor System allows you to perform all configurations that you can imagine.
In my experience, it always matches the guide and the hook, saving surgical time.”
- Dr. Fierro is a shoulder and elbow surgeon at Fundación Santa Fe de Bogotá and clinical professor at Universidad de los Andes in Bogotá – Colombia. He’s an academician and scientist with peer-reviewed publications related to shoulder and elbow surgery.
- D. Fierro completed his specialization in orthopedics and traumatology at the Universidad del Rosario in Bogotá. He performed his fellowship at Fundacion Santa Fe de Bogotá and has training and experience with some of the best shoulder and elbow surgeons in the world, including the Mayo Clinic, Baylor University Medical Center and Tulane Institute of Sports Medicine.