Arthroscopic transtendon repair of partial articular-sided supraspinatus tendon avulsion

Vinanti, Giovanni Battista; Rossato, Alberto; Scrimieri, Daniele; Petrera, Massimo

doi:10.1007/s00167-015-3953-5

Cited by 20 publications

(15 citation statements)

References 32 publications

(83 reference statements)

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“…All patients experienced failed conservative treatment for at least 3 months preoperatively, including activity modification, nonsteroidal anti-inflammatory drugs, physiotherapy, and steroid injection. The exclusion criteria were as follows: (1) prior surgery history on the same shoulder; (2) other severe combined pathologies including chondral damage, Bankart lesions, greater tuberosity fractures, and bicep tendon ruptures on the same shoulder; (3) cases with less than a 1-year follow-up after surgery; (4) severe systemic disease; (5) diabetes with an unsatisfactory control; and (6) excluded by arthroscopy.…”

Section: Methodsmentioning

confidence: 99%

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Arthroscopic knotless single-row repair preserving full footprint versus tear completion repair for partial articular-sided rotator cuff tear

Liu

et al. 2018

J Orthop Surg (Hong Kong)

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Footprint-preserving knotless single-row repair obtains similar clinical results compared to tear completion repair in the treatment of articular-sided PTRCTs. Footprint-preserving knotless single-row repair may be a convenient choice for the treatment of articular-sided PTRCTs. Randomized controlled studies are needed to investigate whether the footprint-preserving knotless single-row repair yields better long-term outcomes through the protection of the bursal cuff and restoration of the healthy footprint.

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Section: Methodsmentioning

confidence: 99%

“…Partial-thickness rotator cuff tears (PTRCTs) are common in orthopedic clinics causing shoulder pain and disability in middle-aged patients. 1 PTRCTs can be divided into three subtypes: articular-sided, intratendinous, and bursal-sided tears. 2 Articular-sided tears are two to three times more common than bursal-sided tears.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic knotless single-row repair preserving full footprint versus tear completion repair for partial articular-sided rotator cuff tear

Liu

et al. 2018

J Orthop Surg (Hong Kong)

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“…Of these 17/20 were retrospective case series including single surgeon data for 1069 shoulders. 2,19,20,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Mean follow-up was 35 months (range 18-60). Two of these 17 case series compared transtendinous repair with completion repair in a single surgeon series in terms of pain and function; however, each of these papers uses completely different outcome scoring systems, with one employing the CMS and SST, the other using ASES score with a visual analogue score for pain.…”

Section: Case Series and Technical Notesmentioning

confidence: 99%

“…All the techniques employed demonstrated significant increases in the outcome scores chosen by the respective authors. 20,21,[24][25][26][27][28][29][31][32][33][34] The remaining 3/15 papers were concerned with other aspects of PASTA repair. 2,29,34 Habermeyer et al compared a new classification system quantifying tears in two planes (coronal and sagittal) with established Ellman and Snyder classifications which use one plane only (sagittal).…”

Section: Case Series and Technical Notesmentioning

confidence: 99%

Partial articular supraspinatus tendon avulsion: Should we repair? A systematic review of the evidence

Tennent

Green

2019

Shoulder & Elbow

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Introduction Partial articular sided rotator cuff tears are described as being a common cause of shoulder pain and to have a significant impact of patient quality of life. The natural history of partial articular supraspinatus tendon avulsion lesions is not clearly defined and there is limited evidence to determine optimal management. Aims To perform a systematic review of the literature regarding the evidence for partial articular supraspinatus tendon avulsion repair and to determine whether there is any difference between operative and non-operatively managed patients. Methods Conventional and grey literature were searched with defined terms to identify studies in human adults concerning management of partial articular sided supraspinatus avulsions. Results Out of 86 papers identified by the search terms, 28 were deemed eligible for review including 1966 shoulders. 4/28 papers were of level I–II evidence but all were comparing techniques. 4/28 papers were biomechanical cadaveric studies, assessing strength of repair and effect on stability. The remaining 20 studies were level IV–V evidence and consisted of case series and technical notes identifying varying techniques of repair and their outcomes. Conclusion Current literature suggests that all techniques used to repair partial articular supraspinatus tendon avulsion lesions give increased functional scores and reduced pain. However, this represents a heterogeneous group of patients with variable degrees of tear and is not reproducible. There are limited controlled studies to determine whether partial articular supraspinatus tendon avulsion lesions require repair. Current classification systems represent a single plane and are open to user variation. No evidence exists to determine which tears are stable and which may progress.

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“…Partial-thickness rotator cuff tears are responsible for significant shoulder pain and limitation of function. 1 According to Ellman, 2 partial-thickness rotator cuff tears can be classified based on arthroscopic findings and on the location of the tear (A, articular; B, bursal; and C, intratendinous), as well as the depth of the tear (grade 1, <3 mm; grade 2, 3-6 mm; and grade 3, >6 mm). Articular-sided partial-thickness rotator cuff tears of the supraspinatus tendon were termed PASTA (partial articular supraspinatus tendon avulsion) by Millstein and Snyder.…”

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confidence: 99%

Aquarium Portal Technique for PASTA Lesion Repair

Meyer

Gerber

Familiari

2017

Arthroscopy Techniques

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The simultaneous arthroscopic exposure of the subacromial and intra-articular space of the shoulder is challenging in the presence of only partial-thickness rotator cuff tears. We present our experience and method of entering the joint through the opened rotator cuff interval from an anterosuperior portal between the coracoid process and anterior acromion. With moderate (approximately 30°) abduction and external rotation, the rotator interval opens readily, offering a view with the camera toward the anterior edge of the supraspinatus tendon. An anterior view on the anterior leading edge of the supraspinatus tendon is obtained, showing the subacromial space above and the glenohumeral space below the tendon, similar to the view in an aquarium. The rotator cuff can be elevated using a rod inserted intra-articularly from posterior, whereas anchors and other instruments may be inserted from lateral. This approach offers the advantages of full exposure of the posterior undersurface of the rotator cuff insertion; a convenient approximately 90° angle between the camera and instruments; and no need to change portals for anchor placement, tendon stitching, or suture handling. The objective of this Technical Note is to describe our arthroscopic repair approach (aquarium technique) to PASTA (partial articular supraspinatus tendon avulsion) lesions.

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Arthroscopic transtendon repair of partial articular-sided supraspinatus tendon avulsion

Abstract: IV.

Cited by 20 publications

References 32 publications

Arthroscopic knotless single-row repair preserving full footprint versus tear completion repair for partial articular-sided rotator cuff tear

Arthroscopic knotless single-row repair preserving full footprint versus tear completion repair for partial articular-sided rotator cuff tear

Partial articular supraspinatus tendon avulsion: Should we repair? A systematic review of the evidence

Aquarium Portal Technique for PASTA Lesion Repair

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