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Rotator Cuff Repair with Cuffmend and Tissuetak Augment
Dr. Garcia specializes in complex knee, shoulder and elbow sports surgeries. He has prepared a number of surgical videos below to help patients better understand their procedures. He is frequently updating his surgical video database so check back soon for further updates.
This video features Dr. Grant Garcia demonstrating his specialized technique for an arthroscopic distal clavicle excision (also known as the Mumford procedure). This surgical intervention is commonly performed for patients suffering from severe acromioclavicular (AC) joint arthritis, chronic weightlifter's shoulder (osteolysis of the distal clavicle), or impingement that causes persistent pain at the top of the shoulder.
The procedure is executed through the following key clinical steps:
- Portal Placement & Viewing: Dr. Garcia establishes standard arthroscopic portals, utilizing the posterior portal for primary viewing and an anterior or anterosuperior portal for instrumentation. This gives him direct, clear visualization of the underside of the AC joint space.
- Debridement of the AC Joint: A radiofrequency (RF) wand and a mechanical shaver are introduced to clear out inflamed subacromial bursa tissue, hypertrophied ligaments, and debris surrounding the joint. This debridement uncovers the exact junction where the collarbone (clavicle) meets the shoulder blade (acromion).
- Bone Resection (The Excision): Using a specialized arthroscopic bone burr, Dr. Garcia carefully resects (shaves away) the diseased or arthritic outer end of the clavicle. He typically removes roughly 8 to 10 millimeters of bone, creating a clean, visible gap between the two bones.
- Coplanar Alignment & Inspection: Throughout the burring process, care is taken to maintain a flat, uniform cut parallel to the acromion edge to avoid any sharp ridges or uneven bone shelves. Dr. Garcia uses an arthroscopic probe to feel the gap, checking the shoulder through a range of motion to ensure the bones can no longer rub together or "impinge" during arm movement.
The final inspection confirms a completely clear, decompression gap that eliminates bone-on-bone friction, effectively relieving the patient's localized pain while fully preserving the overarching stability of the AC joint ligaments.
