Is Posterior Delamination in Arthroscopic Rotator Cuff Repair Hidden to the Posterior Viewing Portal?

Does partial tear repair of adjacent tendons improve the outcome of supraspinatus tendonfull-thickness tear reinsertion?

“…Based on our results, we believe curettage and closure of delamination tears of infraspinatus or subscapularis tendons represent a reasonable option to obtain a water tight cuff at the end of the repair, conversely to others who complete these tears to full thickness prior to repair [17]. In addition, the conservative treatment of delaminated tendon allows the preservation of tendon bony insertions, which has been suggested to be the weakest link in the chain of the tendon repair [18,22,23]. Tenodesis of the long head of the biceps restored satisfying function, similar with shoulders with spontaneously stable biceps tendons.…”

“…Tenodesis of the long head of the biceps restored satisfying function, similar with shoulders with spontaneously stable biceps tendons. Last, it was recently suggested that posterior delamination were hidden, and likely to be left untreated, while using solely the posterior viewing portal during arthroscopic repair [22].…”

Delaminated rotator cuff tear: extension of delamination and cuff integrity after arthroscopic rotator cuff repair

“…7 The incidence of delaminated rotator cuff tears ranged from 38% to 82% in previous reports. 1,5,12,17 Han et al 7 reported that the incidence of posterior delamination in rotator cuff tears was extremely high (92% overall incidence). Detailed studies of delaminated rotator cuff tears have demonstrated their importance as prognostic factors after arthroscopic rotator cuff repair.…”

Arthroscopic Lamina-Specific Double-Row Fixation for Large Delaminated Rotator Cuff Tears

“…The anterolateral portal is also used as the viewing portal to prevent the surgeon from overlooking posterior delamination. 3 Delamination is evaluated by pulling the torn superior and inferior layers laterally to the footprint using a tendon grasper with a 7-mm bite (Fig 1). If the edge of the inferior layer can be grasped and pulled laterally to the footprint with the grasper, we regard this inferior layer as thick and tough tissue.…”

“…D elamination is a commonly observed finding at the time of rotator cuff repair, [1][2][3][4][5][6] and some clinical studies have reported it as a negative prognostic factor in rotator cuff healing. 1,2 Although the definitive diagnosis of delamination mainly depends on operative findings, little information is available about the histologic and anatomic analysis of delamination, and few studies have described the surgical techniques used for delaminated rotator cuff tears (RCTs) or their clinical outcomes.…”