title: Clinical and magnetic resonance imaging results of arthroscopic full-layer repair of bursal-side partial-thickness rotator cuff tears.
abstract: BACKGROUND
  Partial rotator cuff tears are being diagnosed more often because of high-resolution magnetic resonance imaging (MRI). Articular-side partial tears are much more common than bursal-side tears, and all-inside or PASTA repairs that preserve the bursal tissue have gained popularity. In contrast, there have been few reports about preserving the articular tissue during bursal tear repair.
  
  
  OBJECTIVE
  To report clinical and radiological results of bursal-side partial-thickness rotator cuff tear (PTRCT) repair with preservation of as much of the intact articular-side tendon as possible.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  From May 2006 to March 2008, 109 patients with PTRCT underwent arthroscopic repair. Among them, 38 consecutive patients who received a full-layer repair on the bursal side for greater than 50% thickness PTRCT were retrospectively evaluated. All repairs were performed with a technique that preserved intact articular fibers. To assess the outcome, pain visual analog scale (PVAS), American Shoulder and Elbow Surgeon (ASES) score, and Constant score were evaluated at final follow-up. Postoperative MRI at least 6 months after surgery was evaluated for repair integrity.
  
  
  RESULTS
  All 38 patients (21 men and 17 women) were available for final follow-up. The mean age at surgery was 50.8 years (range, 30-58 years), and the mean follow-up time was 26.9 months (range, 24-41 months). There were 21 right shoulders and 17 left shoulders, for which the mean time from the onset of symptoms to surgery was 47.0 months (±83.3 months). The PVAS improved from 5.2 (±2.5) to 1.6 (±1.5), and mean ASES and Constant scores improved from 53.1 (±20.4) and 59.9 (±15.3) to 87.2 (±9.4) and 83.2 (±12.0), respectively. Postoperative MRI was available in 33 patients at a mean 8.2 months after surgery. Twenty-nine shoulders (87.9%) had an intact repaired tendon, while 3 patients had shown partial-thickness delaminated retears, and 1 patient demonstrated a full-thickness retear on postoperative MRI.
  
  
  CONCLUSIONS
  For bursal-side PTRCT, clinical outcomes and tendon healing showed good results at a minimum 2 years after surgery, with minimal damage to intact articular tendon fibers on postoperative MRIs.
authors: Department of Orthopaedic Surgery, Samsung Medical Center, SungKyunkwan University School of Medicine, Seoul, Korea.
authors: Kyoung Hwan
authors: KH
authors: Koh
authors: Min Soo
authors: MS
authors: Shon
authors: Tae Kang
authors: TK
authors: Lim
authors: Jae Chul
authors: JC
authors: Yoo
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery; D013708:Tendon Injuries / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing