Posted on February 9, 2011



Rotator cuff surgery has undergone significant improvements over the past decade due to improved materials and techniques. Transosseous Equivalent (TOE) Repair is a new technique which is utilized by physicians at Orthopaedic and Neurosurgery Specialists PC (ONS) at Greenwich Hospital, and was the subject of a recent study by the ONS Foundation for Clinical Research and Education. The healing rates of two-tendon rotator cuff tears repaired with the new suture bridging technique were examined, and the results indicated dramatic improvements in patient healing rates. The research was documented in a paper authored by ONS orthopedic surgeons Paul Sethi, MD; James Cunningham, MD; and Seth Miller, MD, and recently published in the Journal of Shoulder and Elbow Surgery.

The study included over 40 ONS patients who underwent arthroscopic rotator cuff surgery using the TOE repair. One year later, they were evaluated with an MRI scan. The ONS Foundation study showed that use of the new suture bridge repair resulted in exceptionally high success rates including patients with large rotator cuff tears.

A study by ONS orthopedic surgeons Seth Miller, MD; James Cunningham, MD; and Paul Sethi, MD of ONS was recently published in the Journal of Shoulder and Elbow Surgery.

“Surgical repairs, performed either arthroscopically or open, have had inconsistent rates of healing. Furthermore, the larger the tear- the more likely the repair is to fail,” said Dr. Sethi. “Patients may notice some improvement post surgery, even when the tendon has not completely healed. However when the tendon successfully heals to the bone, patients experience less pain and greater post-operative strength. The TOE technique significantly increases the chance of complete recovery.”

The Journal of Shoulder and Elbow Surgery is the only peer-reviewed publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the shoulder, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials.  Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.


Article Reference: Sethi PM, Noonan BC, Cunningham J, Shreck E, Miller S. Repair results of 2-tendon rotator cuff tears utilizing the transosseous equivalent technique. J Shoulder Elbow Surgery (2010) 19, 1210-1217.

ONS Foundation for Clinical Research and Education, Inc. is a registered not-for-profit, 501(c)3 organization devoted to understanding the causes and optimal treatments of orthopedic injuries and musculoskeletal conditions. The ONS Foundation, in alliance with Greenwich Hospital, strives to improve standards of excellence for the treatment of musculoskeletal disorders through clinical research, physician and patient education, and community outreach programs.  The office is located at 6 Greenwich Office Park, 10 Valley Drive, Greenwich, CT. For further information visit or call (203) 869-3131.