The Signature Orthopaedics Arthroscopic Trans-Osseous Knotless Shoulder Anchor (ATOK) is designed to perform a transosseous rotator cuff repair, using a knot-less arthroscopic approach.

The traditional TRAN-OSSEOUS 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 the 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. There are a number of compromises that 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.

The ATOK anchor allows reattachment of the disrupted rotator cuff, and in particular the Supraspinatus and Infraspinatus tendons, using an arthroscopic or mini-open approach. Although the ATOK anchor can be used without special instruments, to take advantage of the special capabilities, a specific set of instruments has been developed to facilitate insertion of the sutures and hub, tensioning the repair sutures, and securing them with the locking plug.

The instruments are supplied in a self-contained specifically designed tray containing:

  • Trans-osseous suture passing guide and capture drill
  • Sleaves for suture and soft tissue protection
  • Suture tensioning device and plug engager

You will also need to order:

  • ATOK anchors – two-part sterile pack containing ATOK hub and ATOK plug.
  • Nitinol passing wire (supplied by Signature Orthopaedics)

To order the ATOK anchor, contact Signature Orthopaedics, or call David Bing on 0407 241 872 for more information.

Caution: Australian and U.S. Federal law restricts this device to sale by or on the order of a physician.