Transosseous or Transosseous-Equivalent Rotator Cuff Repair: The Difference

Abstract

The rotator cuff healing process occurs in a special environment because it happens between the tendon and bone. Rotator cuff (RTC) re-tears after surgical repair continue to be a prevalent problem. Despite advances in surgical technique, re-tears occur at rates of 11%–57% (Le et al. 2014). Risk of re-tear has been attributed to many modifiable and non-modifiable factors, including patient age, size and pattern of initial tear, repair technique, and tendon quality (Le et al. 2014; Duquin et al. 2010; Millett et al. 2014; Nho et al. 2009; Chillemi et al. 2011). In a recent study (Chillemi et al. 2011), were detected and listed the most important histopathological findings of ruptured tendons, which consisted mainly in disarray (i.e., loss of structural organization), poor or absent neoangiogenesis, chondral metaplasia, and fibrosis. All these features may give to tendon tissue a low healing capability, so these aspects may therefore explain why the lesions of the rotator cuff are at high risk of re-tear. Taking into considerations these observations, was so introduced a new concept of rotator cuff tendon “non-healing” (i.e., a condition of healing failure) rather than re-tear.