Bubble Sign: An Arthroscopic Technical Trick to Differentiate Between Partial- and Full-Thickness Rotator Cuff Tears

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Diagnostic Arthroscopy

Background:

• Accurate differentiation between partial-thickness and small full-thickness rotator cuff tears is essential for optimal patient care.
• Current diagnostic methods may face challenges in precisely identifying small full-thickness tears of the superior rotator cuff.

Purpose of the Study:

• To present a straightforward intraoperative technical maneuver for identifying small full-thickness tears of the superior rotator cuff during arthroscopy.

Main Methods:

• The technique leverages the natural pressure gradient between the subacromial space (high pressure) and the glenohumeral joint (low pressure).
• The supraspinatus tendon acts as a barrier; a full-thickness tear allows fluid and air to flow from the subacromial space into the glenohumeral joint.
• Observation of air bubble movement into the glenohumeral joint serves as the diagnostic indicator.

Main Results:

• The described technique provides a simple and effective method for intraoperatively identifying the presence of full-thickness rotator cuff tears.
• This visual cue aids surgeons in making critical decisions regarding surgical treatment and repair strategies.

Conclusions:

• The air bubble flow sign is a valuable addition to the diagnostic arthroscopic armamentarium for rotator cuff pathology.
• This technique can improve the accuracy of diagnosing small full-thickness rotator cuff tears, leading to more tailored surgical interventions.