Bursal-Sided Rotator Cuff Tears: Simple Versus Everted Type.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Radiology

Background:

• Bursal-sided partial-thickness rotator cuff tears (PTRCTs) are common, but the everted type has not been specifically studied.
• Understanding the unique characteristics of everted PTRCTs is crucial for effective treatment.

Purpose of the Study:

• To investigate the radiological features, arthroscopic findings, and clinical outcomes of arthroscopic repair for the everted type of bursal-sided PTRCTs.
• To compare these findings with the simple type of bursal-sided PTRCTs.

Main Methods:

• A cohort study comparing 25 patients with everted PTRCTs and 25 with simple PTRCTs.
• Radiological assessment (MRI), arthroscopic evaluation, and clinical outcome measures (VAS, ROM) were used.
• Follow-up averaged 2.7 years.

Main Results:

• Everted PTRCTs consistently showed acromial spurs (hat-shaped or heel-shaped) and greater tuberosity bony changes.
• MRI revealed significantly thicker tendon stumps in the everted type due to superomedial retraction.
• Arthroscopic repair required additional sutures more frequently for the everted type (64% vs 16%) due to ragged margins, though postoperative outcomes were similar.

Conclusions:

• The everted type of bursal-sided PTRCTs presents characteristic radiological findings, including acromial spurs and thickened tendon stumps on MRI.
• Arthroscopic repair of everted PTRCTs may necessitate additional sutures but yields satisfactory clinical and structural results comparable to the simple type.