For the first time in Lithuania, a screwless system was used to perform reconstructive surgery of the shoulder joint

At the end of February, for the first time in the country, arthroscopic reconstructive operations of the rotator cuff tendons of the shoulder joint were performed in Kaunas clinics, during which a screwless system was used for tendon fixation for the first time in Lithuania. “Shoulder joint reconstructive operations are needed by patients after severe shoulder injuries, when the rotator cuff tendons that rotate the shoulder, lift it, and help it move are torn,” said Prof. Rimtautas Gudas, Head of Sports Trauma and Arthroscopy Department of Kaunas Clinics Orthopedic Traumatology Clinic. “Operation with the new system will make it easier for doctors to work, increase the probability of tendon attachment to the humerus tuberosity, and patients will feel less pain in the postoperative period.”

During arthroscopic surgery, the rotator cuff tendons need to be attached to the bone using anchoring screws that are screwed into the patient’s humerus. In order to ensure strong fixation of the tendons of the shoulder, it may be necessary to use as many as four or even more such screws per patient. “Anchoring screws sometimes migrate or even fail to hold because some people have soft (porous) bone, which causes the screws to come loose and require repeat shoulder surgery,” explained the professor.

Prof. Rimtautas Gudas. / Photo of Kaunas clinics.

Thanks to the new system, fixation is performed minimally invasively through channels made with the help of a special system, through which, at the same time, through the ruptured tendons, strong fixation threads are passed endoscopically, which press the ruptured tendons to the bone. “The advantage of this system is that channels away from the tendons are made in strong bone, the so-called cortical bone, which significantly reduces the risk of the fixation threads cutting the bone,” said Prof. R. Good.

“The system makes it possible to reconstruct even very large rotator cuff tears of the shoulder without the use of anchoring screws,” said Prof. R. Good. “The new system is characterized by an exceptionally high fixation force, and when fixing the tendons, they are attached to the bone by widely and evenly distributing the fixation forces over a larger area, thus avoiding strong pressure in only one place of the bone.” The head of the sports trauma and arthroscopy sector added that the new method it also helps prevent screw migrations or protrusions that occur, reduces the risk of infection, because there are no implants where bacteria form dangerous colony films.

Photo of Kaunas clinics.

The new system provides not only economic benefits – no expensive anchoring screws are used during the operation, but also allows patients to recover faster after the operation. “It has been observed that when the tendons are fixed with special fixation threads (without anchoring screws), patients consume significantly less painkillers, they do not need narcotic analgesics,” noted the professor. “Meanwhile, when tendons are fixed with anchoring screws, patients feel somewhat stronger pain, they often need narcotic analgesics, and they consume more painkillers during the entire healing period.”

Prof. R. Gudu’s first rotator tendon fixation operation with this system was helped by Dr. Filip Hudeček, an orthopedic doctor working in the Czech Republic. He has already performed over 800 such operations worldwide. Dr. F. Hudeček believes that the doctors of the Kaunas Clinics are a particularly experienced, professional, proactive team that will successfully perform reconstructive surgeries of the shoulder joint using this system in the future.

“Our goal is to spread the word about this innovation, in the future to teach as many colleagues as possible how to operate shoulder joints in a new way, in order to avoid protrusions of the anchoring screws and to help the country’s patients feel better,” said Prof. R. Good.

Photo of Kaunas clinics.