Arthroscopic transtendon repair of partial-thickness articular-side tears of the rotator cuff: anatomical and clinical study.
BACKGROUND
The precise results of arthroscopic transtendon repair of partial-thickness articular-side tears of the rotator cuff remain to be reported.


OBJECTIVE
Arthroscopic transtendon repair is useful in patients with Ellman grade 3 (>6 mm) partial-thickness articular-side tears of the supraspinatus tendon.


METHODS
Descriptive laboratory study and case series; Level of evidence, 4.


METHODS
In 43 cadaveric shoulders (mean age, 80 years; range, 50-97 years), the authors measured the width of the supraspinatus insertion (medial-to-lateral direction) and the distance between the articular cartilage edge and the tendon insertion at a site 10 mm lateral to the anterior margin of the greater tuberosity. A clinical study group of 17 patients (mean age, 42 years; range, 17-51 years) was observed for a mean follow-up of 39 months (range, 25-57 months). University of California at Los Angeles and Japanese Orthopaedic Association shoulder scores and postoperative overhead athletic activities were evaluated.


RESULTS
The mean width of the supraspinatus insertion was 9.6 mm (SD, 1.6 mm; range, 7-13 mm; 95% confidence interval, 9.1-10.1 mm; 95% prediction interval, 6.4-12.8 mm). The mean distance between the articular cartilage edge and the tendon insertion was 0.3 mm (range, 0-2 mm). After the procedure, the mean University of California at Los Angeles and Japanese Orthopaedic Association scores significantly improved from 17.3 and 68.4 points to 32.9 and 94.8 points, respectively (P < .01). Rated on the Japanese Orthopaedic Association scale, results were excellent in 14, good in 2, and fair in 1 patient; there were no poor results. Of 6 overhead-throwing athletes, 2 returned to their previous sports at the same level, 3 returned at a lower level, and 1 was unable to return.


CONCLUSIONS
Arthroscopic transtendon repair is a safe, reliable procedure in patients with grade 3 partial-thickness articular-side tears. In the majority of patients, partial tears of more than 6 mm of the supraspinatus tendon thickness involved more than 50% of the entire tendon thickness.
Ide
Junji
J
Department of Orthopaedic Surgery, Kumamoto University Hospital, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan. ide@kaiju.medic.kumamoto-u.ac.jp
Maeda
Satoshi
S
Takagi
Katsumasa
K
D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods*; D001265:Athletic Injuries / Q000473:pathology / Q000601:surgery; D002102:Cadaver; D002358:Cartilage, Articular / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome