Summary

For grade III PASTA lesion, transtendon double-row fixation exhibited superior biomechanical properties and satisfied clinical outcomes.

Abstract

Introduction

The standard technique for repairing partial-thickness tears of the rotator cuff includes completion of the lesion to a full-thickness tear. Grade III partial articular supraspinatus tendon avulsion (PASTA) form a subgroup deserving special consideration. We present a transtendon suture bridge technique for this subgroup of pts.

Methods

Thirty-six patients with isolated PASTA lesions treated by transtendon suture bridge repair were included and retrospectively reviewed. One or two medial row anchors were put though supraspinatus tendon. The retracted tendon was reduced with a tissue grasper or a traction suture. The trans-tendon repair technique was used. The sutures of medial row anchors were tied and then fixed to the greater tubercle with double-row suture bridge technique. All patients were evaluated preoperatively and at a mean of 21.2 months (±9.7 months) postoperatively using standardized clinical evaluation (physical exam, American Shoulder and Elbow Surgeons, and Simple Shoulder Test). All patients underwent postoperative imaging with a MRI arthrogram.

Results

There was a significant improvement in American Shoulder and Elbow Surgeons (42.7±17.5 to 86.9±25.2) and Simple Shoulder Test (4.6±3.2 to 10.1±3.8) scores from pre- to postoperative, respectively. At 3 months from surgery, radiographic healing of the tendon was noted and integrity of the supraspinatus tendon insertion to the footprint was confirmed by arthro-magnetic resonance imaging, with full recovery of daily activities and complete active range of motion confirmed at 6 and 12 months.

Conclusion

For grade III PASTA lesion, transtendon double-row fixation exhibited superior biomechanical properties and satisfied clinical outcomes.