Partial-thickness articular surface rotator cuff tears: an all-inside repair technique

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Arthroscopy

Background:

• Partial-thickness rotator cuff tears present treatment challenges, with existing methods risking stiffness or damaging healthy tissue.
• Current techniques include débridement, acromioplasty, transtendinous repairs, or completing the tear for full-thickness repair.
• A novel technique was developed for articular-side partial-thickness tears using an all-inside approach, preserving bursal tissue and intact tendon.

Purpose of the Study:

• To evaluate the Penn Shoulder Score (PSS) changes after an in situ all-inside rotator cuff tear repair.
• To assess the impact of this technique on postoperative shoulder stiffness.

Main Methods:

• Retrospective review of 20 patients with partial-thickness articular rotator cuff tears (>50% width) repaired with an all-inside technique.
• Patients were primarily recreational athletes, with a minimum follow-up of 16 months (average 29 months).
• Clinical outcomes were assessed using the PSS, and postoperative range of motion (ROM) was measured.

Main Results:

• The average PSS significantly improved from 74 to 92 post-surgery.
• The vast majority of patients (all but one) returned to their previous or a higher level of athletic activity.
• No major cases of postoperative clinical stiffness were reported.

Conclusions:

• The in situ all-inside repair technique offers a substantial improvement in clinical outcomes for partial-thickness articular rotator cuff tears.
• This method effectively addresses these injuries without causing significant postoperative stiffness.
• The technique allows athletes to return to their sport at a high level.