Related Experiment Video
Updated: May 15, 2026
Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
Subacromial bursa augmentation in arthroscopic rotator cuff repair: Clinical and doppler ultrasound assessment-A
Florian Freislederer1, Mara Dimitriu1, David Endell1
1Department of Shoulder and Elbow Surgery Schulthess Klinik Zürich Switzerland.
Purpose:
To determine whether augmentation with the subacromial bursa influences postoperative tendon healing, particularly regarding morphology and vascularity, after arthroscopic rotator cuff repair.
Methods:
In this prospective comparative study (2019-2023), patients with crescent-shaped posterosuperior rotator cuff tears (SSP ± ISP, Lafosse ≤ 1), tendon retraction Patte ≤ 2, and fatty infiltration Goutallier ≤ 2 underwent double-row arthroscopic repair with (Bursa Group) or without (Control Group) bursa augmentation. Postoperative vascularity and tendon integrity were assessed via Doppler ultrasound at 3, 6, 12 and 24 weeks. Secondary outcomes included pain and functional scores.
Results:
Thirty patients (mean age 60) were analysed: 20 in the Bursa Group and 10 in the Control Group. The Bursa Group showed an initial increase in bursal vascularity at 3 weeks, which declined similarly in both groups thereafter. At 6 weeks, neovascularity at the tendon insertion showed an increase in the Bursa Group, while it significantly decreased in controls (p = 0.032). Pain scores were lower in the Bursa Group, with statistically significant but small differences at 6 weeks at rest (mean VAS 1 ± 1 vs. 3 ± 2, p = 0.013) and at 3 months during activity (mean VAS 3 ± 2 vs. 5 ± 2, p = 0.009), while no significant differences were observed at other time points. Tendon thickness was better preserved in Group B at 3 (p = 0.029) and 6 months (p = 0.007). Functional outcomes were comparable after 6 months. Three retears occurred in Group B, while no retears were observed in Group C.
Conclusion:
Clinical outcomes were similar between bursa-augmented rotator cuff repair and the control group. While bursa augmentation did not enhance neovascularization compared to controls, it was associated with better tendon thickness preservation and reduced pain, although these differences were marginal and limited to selected early follow-up time points.
Level Of Evidence:
Level III, evidence study.
