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Updated: May 15, 2026
Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
Published on: January 23, 2026
The correlation between torn supraspinatus tendon thickness and commonly used radiological predictive factors for
Chang-Lin Wu1,2, Poyu Chen3,4, Cheng-Pang Yang3,5,6
1Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Background:
Pre-operative imaging evaluation is critical in determining the correct surgical indication and healing rate of rotator cuff repairs. While factors like supraspinatus (SSP) muscle fatty infiltration (FI), tangent sign, remnant tendon length, and acromiohumeral distance (AHD) are well-recognized to predict the reparability of SSP, a comprehensive understanding of the interplay between various torn tendon characteristics, like remnant tendon thickness, remains limited.
Study Design:
Level III, Retrospective cohort study.
Methods:
A retrospective analysis was conducted on 200 patients who underwent rotator cuff-related surgery. Preoperative radiographs and MRI scans were assessed independently by two observers. Patients were classified as either repairable or irreparable based on the extent of SSP FI (reparable is defined as SSP muscle FI of Goutallier stage ≦ 2, while irreparable is defined as SSP muscle FI of Goutallier stage > 2, reflecting common surgical decision-making for procedures beyond standard repair). The study's primary aim was to explore the correlation between pre-operative imaging parameters and the established radiographic definition of irreparable SSP tears (SSP muscle FI of Goutallier > 2), which guides initial surgical planning. The statistical analysis was performed.
Results:
Out of the 200 cases, 156 were repairable, and 44 were irreparable. Significant differences were observed in remnant SSP tendon length, tear size, and tendon thickness between the two groups. The mean SSP tendon thickness was 4.6 ± 0.7 mm in the repairable group and 3.4 ± 0.8 mm in the irreparable group. Using ROC analysis, a cut-off value of 3.9 mm for irreparable SSP tendon thickness was determined. A significant decrease in SSP tendon thickness was also associated with SSP Goutallier Stage > 2 muscle FI, positive SSP tangent sign, and modified Patte 3 SSP tear. Positive digitation signs were prevalent in 81% of Lafosse type I and II, and 100% in Lafosse type III and IV subscapularis (SSC) tears. SSP remnant tendon thickness significantly decreased when in SSC tear more than Lafosse type I, SSC FI > 1, and a positive digitation sign.
Conclusions:
This study highlights the interrelationships between radiographic parameters and their impact on SSP reparability. A remnant SSP tendon thickness of > 3.9 mm appears to be an independent predictor of reparability, demonstrating good sensitivity and specificity in this study.
