Advertisement

Delaminated Tears of the Rotator Cuff: The Rationale and Techniques for the Double-Row Repair

  • Enrique Salas
  • Guillermo Arce
  • Gustavo Matheus
Chapter

Abstract

The rotator cuff is constituted by the tendons of the supraspinatus, infraspinatus, and teres minor muscles, and it has more than one layer. Delamination represents a horizontal separation of the tendon layers in the setting of a ruptured rotator cuff. Histologically, delamination occurs between two layers of collagen fibers with a different fiber orientation [1].

Keywords

Rotator cuff Delaminated Tears Pattern 

References

  1. 1.
    Sonnabend DH, Yu Y, Howlett CR, Harper GD, Walsh WR. Laminated tears of the human rotator cuff: a histologic and immunochemical study. J Shoulder Elb Surg. 2001;10:109–15.CrossRefGoogle Scholar
  2. 2.
    Mochizuki T, Sugaya H, Uomizu M, et al. Humeral insertion of the supraspinatus and infraspinatus. New anatomical findings regarding the footprint of the rotator cuff. J Bone Joint Surg Am. 2009;91. Suppl 2 Pt:1:1–7.CrossRefGoogle Scholar
  3. 3.
    Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am. 2005;87:1229–40.PubMedGoogle Scholar
  4. 4.
    Cha SW, Lee CK, Sugaya H, Kim T, Lee SC. Retraction pattern of delaminated rotator cuff tears: dual-layer rotator cuff repair. J Orthop Surg Res. 2016;11:75.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Mori D, Funakoshi N, Yamashita F. Arthroscopic lamina-specific double-row fixation for large delaminated rotator cuff tears. Arthrosc Tech. 2014;3:e667–71.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Choo HJ, Lee SJ, Kim JH, et al. Delaminated tears of the rotator cuff: prevalence, characteristics, and diagnostic accuracy using indirect MR arthrography. AJR Am J Roentgenol. 2015;204:360–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am. 2007;89:953–60.CrossRefPubMedGoogle Scholar
  8. 8.
    Burkhart SS, Denard PJ, Konicek J, Hanypsiak BT. Biomechanical validation of load-sharing rip-stop fixation for the repair of tissue-deficient rotator cuff tears. Am J Sports Med. 2014;42:457–62.CrossRefPubMedGoogle Scholar
  9. 9.
    MacDougal GA, Todhunter CR. Delamination tearing of the rotator cuff: prospective analysis of the influence of delamination tearing on the outcome of arthroscopically assisted mini open rotator cuff repair. J Shoulder Elb Surg. 2010;19:1063–9.CrossRefGoogle Scholar
  10. 10.
    Matsuki K, Murate R, Ochiai N, Shuhei O. Delamination observed in full-thickness rotator cuff tears. Katakansetsu. 2005;29:603–6.Google Scholar
  11. 11.
    Mihata T, McGarry MH, Pirolo JM, Kinoshita M, Lee TQ. Superior capsule reconstruction to restore superior stability in irreparable rotator cuff tears: a biomechanical cadaveric study. Am J Sports Med. 2012;40:2248–55.CrossRefPubMedGoogle Scholar
  12. 12.
    Mihata T, Lee TQ, Watanabe C, et al. Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthroscopy. 2013;29:459–70.CrossRefPubMedGoogle Scholar
  13. 13.
    Kim YS, Lee HJ, Jin HK, Kim SE, Lee JW. Conventional en masse repair versus separate double-layer double-row repair for the treatment of delaminated rotator cuff tears. Am J Sports Med. 2016;44:1146–52.CrossRefPubMedGoogle Scholar
  14. 14.
    Rush LN, Felix Henry Savoie III, Itoi E. Double-row rotator cuff repair yeild improved tendon structural integrity, but no difference in clinical outcomes compared with single-row and triple-row repair: a sistematic review. Jisakos. 2017;2:260–8.Google Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  • Enrique Salas
    • 1
  • Guillermo Arce
    • 2
  • Gustavo Matheus
    • 3
  1. 1.Department of Orthopaedic SurgeryCentro Medico Docente La TrinidadCaracasVenezuela
  2. 2.Department of Orthopaedic SurgeryInstituto Argentino de Diagnostico y TratamientoBuenos AiresArgentina
  3. 3.Department of Orthopaedic surgeryClinica SantrixCaracasVenezuela

Personalised recommendations