Partial articular surface of the rotator cuff tendon tears has been recognized as a source of treatable shoulder pain and a precursory pathology for full-thickness tendon tears. Arthroscopic rotator cuff repair is a possible surgical method of treatment. Recent data have shown that the treating partial-thickness rotator cuff repairs with transtendon technique shows good clinical outcome. The use of this technique enables the reconstitution of the tendon with complete reconstruction of its footprint without damaging its intact bursal part. In cases of high grade partial articular-sided degenerative rotator cuff tears (involving >50% of the tendon) in older patients, there is a possibility of poor healing or re-tear of the rotator cuff repair, which may be associated with poor tendon quality and substantial thinning of the rotator cuff, subsequently revision surgery in these patients will be demanding.
To mitigate these problems, we describe here a new arthroscopic transtendon repair technique with tenotomized long head biceps tendon augmentation for high grade partial articular rotator cuff tear with the goal of providing increase tendon healing, as well as to minimize the probability of failure of the construct and to improve the clinical outcomes.
The clinical results of the first 39 consecutive patients are reported showing significant decrease in pain and improved shoulder scores, as well as the post-operative range of motion and with no cases of re-tear of the rotator cuff tendon.
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Fukuda H (2003) The management of partial-thickness tears of the rotator cuff. J Bone Joint Surg Br 85:3–11
Ellman H (1990) Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res 254:64–74
Gartsman GM (1995) Arthroscopic treatment of rotator cuff disease. J Shoulder Elbow Surg 4:228–241
Trantalis JN, Boorman RS, Pletsch K, Lo IK (2008) Medial rotator cuff failure after arthroscopic double-row rotator cuff repair. Arthroscopy 24:727–731
Weber SC (1999) Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial thickness rotator cuff tears. Arthroscopy 15:126–131
Budoff JE, Nirschl RP, Guidi EJ (1998) Debridement of partial-thickness tears of the rotator cuff without acromioplasty. Long-term follow up and review of the literature. J Bone Joint Surg Am 80:733–748
Cordasco FA, Backer M, Craig EV, Klein D, Warren RF (2002) The partial thickness rotator cuff tear: is acromioplasty without repair sufficient? Am J Sports Med 30:257–260
Lo IK, Burkhart SS (2004) Transtendon arthroscopic repair of partial-thickness, articular surface tears of the rotator cuff. Arthroscopy 20:214–220
Stetson WB, Phillips T, Deutsch A (2005) The use of magnetic resonance arthrography to detect partial-thickness rotator cuff tears. J Bone Joint Surg Am 87:81–88
Waibl B, Buess E (2005) Partial-thickness articular surface supraspinatus tears: a new transtendon suture technique. Arthroscopy 21:376–381
Peters KS, Lam PH, Murrell GA (2010) Repair of partial-thickness rotator cuff tears: a biomechanical analysis of footprint contact pressure and strength in an ovine model. Arthroscopy 26:877–884
Lippitt SB, Harryman DT II, Matsen FA III (1993) A practical tool for evaluating function: the simple shoulder test. In: Matsen FA III, Fu FH, Hawkins RJ (eds) The shoulder: a balance of mobility and stability. The American Academy of Orthopaedic Surgeons, Rosemont, IL, pp 545–559
Ellman H, Hanker G, Bayer M (1986) Repair of the rotator cuff: End-result study of factors influencing reconstruction. J Bone Joint Surg 68A:1136–1144
Richards RR, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG et al (1994) A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg 347–352
Fukuda H, Hamada K, Nakajima T, Tomonaga A (1994) Pathology and pathogenesis of the intratendinous tearing of the rotator cuff viewed from en bloc histologic sections. Clin Orthop Relat Res 304:60–67
Yamanaka K, Matsumoto T (1994) The joint side tear of the rotator cuff. A follow up study by arthrography. Clin Orthop Relat Res 304:68–73
Matava MJ, Purcell DB, Rudzki JR (2005) Partial-thickness rotator cuff tears. Am J Sports Med 33:1405–1417
Snyder SJ (2003) Shoulder Arthroscopy. Lippincott Williams and Wilkins, Philadelphia
Mazzocca AD, Rincon LM, O’Connor RW, Obopilwe E, Andersen M, Geaney L et al (2008) Intra-articular partial-thickness rotator cuff tears: analysis of injured and repaired strain behavior. Am J Sports Med 36:110–116
Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG (2005) Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am 87:1229–1240
Longo UG, Franceschi F, Ruzzini L, Rabitti C, Morini S, Maffulli N et al (2008) Histopathology of the supraspinatus tendon in rotator cuff tears. Am J Sports Med 36:533–538
Rhee YG, Cho NS, Lim CT, Yi JW, Vishvanathan T (2008) Bridging the gap in immobile massive rotator cuff tears: augmentation using the tenotomized biceps. Am J Sports Med 36:1511–1518
Cho NS, Yi JW, Rhee YG (2009) Arthroscopic biceps augmentation for avoiding undue tension in repair of massive rotator cuff tears. Arthroscopy 25:183–191
Sano H, Mineta M, Kita A, Itoi E (2010) Tendon patch grafting using the long head of the biceps for irreparable massive rotator cuff tears. J Orthop Sci 15(3):310–316
Warren RF (1985) Lesions of the long head of the biceps tendon. Instr Course Lect 34:204–209
Boileau P, Krishnan SG, Coste J-S, Walch G (2002) Arthroscopic biceps tenodesis: A new technique using bioabsorbable interference screw fixation. Arthroscopy 18:1002–1012
Checchia SL, Doneux PS, Miyazaki AN et al (2005) Biceps tenodesis associated with arthroscopic repair of rotator cuff tears. J Shoulder Elbow Surg 14:138–144
Wolfgang GL (1974) Surgical repair of tears of the rotator cuff of the shoulder: Factors influencing the result. J Bone Joint Surg Am 56:14–26
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Ji, J., Shafi, M., Jeong, J. et al. Transtendon arthroscopic repair of high grade partial-thickness articular surface tears of the rotator cuff with biceps tendon augmentation: technical note and preliminary results. Arch Orthop Trauma Surg 132, 335–342 (2012) doi:10.1007/s00402-011-1373-7
- Partial articular
- Rotator cuff tear
- Transtendon repair
- Biceps tendon