New technology enables total arthroscopic shoulder repairs.

For anyone who has ever had a torn rotator cuff, it's hard to imagine that new medical technology is emerging that is literally enabling surgeons to repair torn rotator cuffs without performing open surgery.

But first, a little background ...

Problems of the shoulder are common enough that they touch all of us. Chances are that if you have not personally suffered from a torn rotator cuff, you are aware of a spouse, family member colleague or close friend who has. Shoulder injuries--specifically, torn rotator cuffs--can be caused by trauma or sports activities that involve repetitive overhead motion, such as golf, tennis, swimming and throwing. More commonly, individuals engaged in everyday activities like washing windows, gardening or lifting can experience shoulder injuries due to repetitive overhead arm movement.

Each year, an estimated four million people in the United States seek medical attention for shoulder injuries. Nearly 300,000 will undergo surgical repair of the rotator cuff. The vast majority of these surgeries are performed by "open" or "mini-open" surgical techniques.

And that's the way it's been for many years. Historically, the all-too-common condition of the torn rotator cuff has been treated by open surgery--and perhaps that's why it is one of the conditions that goes untreated with many patients. People are simply scared to go in for a major surgical procedure. In this age of "minimally invasive" medical procedures, many patients have been dealing with the pain or lack of shoulder mobility that a torn rotator cuff causes in the hopes that a minimally invasive treatment option will arise.

This is not a new notion. For years, orthopedic surgeons have sought a means to effectively perform arthroscopic surgery, a minimally invasive surgery technique, to repair torn rotator cuffs. Indeed, some surgeons around the country have seen success performing rotator cuff repairs arthroscopically, but it has been a difficult procedure to teach and perform and clue to the limited visibility and complicated knot-tying involved with the procedure, it has rarely yielded the same level of results as open surgery. Indeed, less than ten percent of rotator cuff repairs are currently performed through minimally-invasive, totally arthroscopic surgery.

Colorado-based orthopedic surgeon Richard Hawkins, M.D., who is founder of the Steadman Hawkins Clinic and head team physician for the Denver Broncos is a long-time proponent and pioneer of arthroscopic procedures. He explains, however, that to become more commonplace, totally arthroscopic procedures must overcome obstacles thai are inherent to the procedure, including the cumbersome "anchor" systems commonly used, the need for improved suture management and the elimination of the knot-tying process.

"The weakest link in arthroscopic rotator cuff repair is the knot tying," said Dr. Hawkins.

"That's because no two arthroscopic knots are tied the same. As a result, arthroscopic cuff repair is difficult to reproduce and leaves a stack of bulky knots in the joint. This is coupled by the challenge and frustration of not being able to rapidly and directly place a secure stitch in the rotator cuff."

Thanks to a series of new and groundbreaking biomedical innovations, a quickly growing number of orthopedic surgeons are beginning to utilize a system designed to eliminate those obstacles.

The minimally invasive "AutoCuff System" made its public debut last year. Developed by California-based Opus Medical, Inc. and a handful of researchers and forward thinking orthopedic surgeons (including Dr. Hawkins), this new FDA-approved technology enables surgeons to perform rotator cuff repair without open surgery or knot-tying of any kind.

The system itself is comprised of two instruments--the SmartStitch Suturing Device and the Magnum Knotless Fixation Implant. When used together, they eliminate the shortcomings of current shoulder repair devices. The SmartStitch Suturing Device delivers a unique "incline" mattress stitch directly into the tissue in a matter of seconds. The surgeon then loads and deploys the Magnum Implant, a device containing an internal mechanism that provides cinchable and reversible suture tension to achieve an excel lent tissue-to-bone interface result--without knots.

Now that thousands of patients have been successfully treated by surgeons around the country utilizing the AutoCuff system, doctors hope this new, minimally invasive treatment option will encourage more individuals to seek treatment for their injured shoulders. For those of us who have suffered with torn rotator cuffs but have been wary of open surgery, this is indeed promising news.

Lyea Chu is a freelance writer specializing in health and medical issues.