Each year, around 10,000 rotator cuff repair surgeries are performed in Australia alone, but traditional methods have shown disappointing outcomes, with failure or re-tear rates between 40% and 60%.
The rotator cuff is a group of muscles and tendons that connect the upper arm bone to the shoulder, enabling movement and stability. Traditional repair techniques for rotator cuff injuries involve either open surgeries or arthroscopic methods using multiple anchors drilled into the bone. Despite advancements, these methods haven’t significantly improved patient outcomes.
“Failure rates are especially high in older patients, leading to a growing trend of reverse shoulder replacements. But research shows that 30% of patients under 60 who get these replacements will need revision surgery during their lifetime,” says Professor Michael Sandow from the University of Adelaide’s Centre for Orthopaedic and Trauma Research (COTR) in Australia. “This is both costly and risky.”
Solution: ATOK Technique
Dissatisfied with the poor success rates of traditional surgeries, Professor Sandow developed a new method called trans osseous knotless anchor (ATOK). This technique secures the rotator cuff tendon to the bone in a way similar to traditional open repairs, but with a twist: it uses arthroscopy and specially designed anchor points manufactured by Australian company Signature Orthopaedics.
The ATOK method eliminates the need for multiple bone anchors, instead providing a more secure and precise attachment of the tendon.
Positive Results
The initial trial of the ATOK method included 15 patients aged 60 and over with severe rotator cuff tears. The outcomes were overwhelmingly positive and were published in the Journal of Shoulder and Elbow Surgery. Professor Sandow later reviewed 155 surgeries performed on patients over 70, with equally encouraging results.
“Only two patients needed shoulder replacements after my surgery, and both were due to bad falls,” says Professor Sandow. “Around 80% of patients reported having no symptoms or only mild symptoms after the procedure.”
One standout case was a 55-year-old man who had failed traditional repairs and was told his only option was a shoulder replacement, which would leave him limited to desk work. After undergoing the ATOK procedure and working with a physiotherapist, he returned to his physically demanding job within three months.
Real-World Impact
According to Professor Dominic Thewlis, Director of COTR, this breakthrough highlights the importance of research aimed at practical outcomes. “ATOK is a prime example of how our work can directly improve lives. Seeing patients regain function and quality of life has been incredibly rewarding,” he says.
The ATOK technique is a promising advancement in the field of orthopaedics, offering hope to patients with rotator cuff injuries who previously had limited options. With its high success rate and minimal need for revision surgeries, it represents a significant step forward in shoulder repair technology.
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