Arthroscopic Trans-Osseous Knotless (ATOK) Shoulder Anchor

This web page demonstrates using the ATOK (Arthroscopic Trans-Osseous Knotless) shoulder anchor, available from Signature Orthopaedics. 

This is not an official Signature Orthopaedics web page. Details and access to the device should be by contacting them via www.signatureortho.com.au

Introduction

The Signature Orthopaedics ATOK anchor is designed to perform a transosseous rotator cuff repair using a knot-less arthroscopic approach.

The traditional technique to repair a disrupted rotator cuff was via an open surgical approach, securing the disrupted rotator cuff tendon margin using sutures and then passing those sutures through bone tunnels to be tied over the lateral humeral cortex.

This produces a reliable repair but with the morbidity and compromised access inherent in open surgery. 

The option to perform the repairs using an arthroscopic approach necessitated a change in the actual repair technique.  This generally involves tying the tendon onto antegrade inserted anchors or, more recently, with the TOE – Trans-Osseous Equivalent repairs.

A number of compromises have become apparent, including the challenges of intracorporeal knot tying, reduced tendon vascularity, reduced contact with the cancellous bone and sub-optimal anchor hold in osteoporotic bone.

By combining the advantages of an open transosseous approach (close approximation of the tendon to the cancellous bone and a strong hold on osteoporotic bone) with the benefits of doing this arthroscopically, the ATOK anchor provides the optimal solution.