title: A comparison of 2 repair techniques for partial-thickness articular-sided rotator cuff tears.
abstract: OBJECTIVE
  This prospective randomized study compared the clinical outcomes of patients who underwent partial-thickness articular-sided rotator cuff repairs by 2 surgical techniques.
  
  
  METHODS
  Forty-eight patients with a symptomatic partial-thickness articular-sided rotator cuff tear exceeding 50% of the tendon thickness were randomly assigned to 2 groups at the time of operation. Of the patients, 24 received arthroscopic rotator cuff repair with a transtendon technique (group I) and 24 received arthroscopic rotator cuff repairs after tear completion (group II). Pain intensity and patient satisfaction were assessed by visual analog scales, and functional outcomes were evaluated by use of American Shoulder and Elbow Surgeons and Constant shoulder scores. Tendon integrity was evaluated by magnetic resonance imaging at 6 months after surgery.
  
  
  RESULTS
  Clinical outcomes were significantly improved after repair in both groups at a mean of 31 months' follow-up. In each group 22 patients (92%) were satisfied with surgery. However, shoulder function and range of shoulder motion recovered faster in group II during the recovery period (American Shoulder and Elbow Surgeons score, 54.9 ± 3.7 in group I v 64.6 ± 3.2 in group II; P = .037) (Constant score, 57.9 ± 2.9 in group I v 70.8 ± 3.3 in group II; P = .019). Furthermore, patients in group I had significantly more pain (5.9 ± 0.4) than patients in group II (2.8 ± 0.5) (P = .001) until 3 months after surgery. Postoperative adhesive capsulitis developed in 3 patients in group I and in 2 patients in group II. According to postoperative 6-month magnetic resonance imaging assessments, all patients in group I achieved complete integrity whereas a retear developed in 2 patients in group II.
  
  
  CONCLUSIONS
  Arthroscopic repair of partial-thickness articular-sided rotator cuff tears exceeding 50% of the tendon thickness provided satisfactory functional improvements and pain relief regardless of the repair technique. Although repair after conversion to a full-thickness tear showed less postoperative morbidity, tendon integrity is of primary concern after repair. On the other hand, the transtendon repair technique resulted in complete tendon integrity but slower functional recovery.
  
  
  METHODS
  Level II, prospective comparative study.
authors: Department of Orthopaedic Surgery, Ewha Womans University School of Medicine, Seoul, South Korea. sjshin622@ewha.ac.kr
authors: Sang-Jin
authors: SJ
authors: Shin
mesh_terms: D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012782:Shoulder / Q000601:surgery; D000070599:Shoulder Injuries; D013708:Tendon Injuries / Q000473:pathology / Q000601:surgery*; D013718:Tensile Strength; D013997:Time Factors; D016896:Treatment Outcome