Partial Rotator Cuff Ruptures

  • Antonio CartuchoEmail author
Part of the European Instructional Lectures book series (EICL, volume 10)


Partial rotator cuff ruptures are not rare and occur mainly in the supraspinatus tendon and may extend to that of infraspinatus, but rarely to the tendon of subscapularis. Isolated lesions in the tendons of infraspinatus, teres minor or subscapularis are rare. Partial ruptures usually occur before the sixth decade of life and can be a cause of unexplained pain in the shoulder giving considerable disability. We performed a systematic literature review and pooled our experience in order to be able to justify the current concepts presented below on this difficult issue.


Rotator Cuff Supraspinatus Tendon Arthroscopic Debridement Subacromial Impingement Partial Tear 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Beaudreil J, Bardin T, Orcel P (2007) Natural History or outcome with conservative treatment of degenerative rotator cuff tears. Joint Bone Spine 74:527–529CrossRefGoogle Scholar
  2. 2.
    Beaudreuil J, Nizard R, Thomas T, Peyre M, Liotard JP, Boileau P, Marc T, Dromard C, Steyer E, Bardin T, Orcel P, Walch G (2009) Contribution of clinical tests to the diagnosis of rotator cuff disease: a systematic literature review. Joint Bone Spine 76:15–19CrossRefPubMedGoogle Scholar
  3. 3.
    Bey MJ, Ramsey ML, Soslowsky LJ (2002) Intratendinous strain fields of the supraspinatus tendon: effect of a surgically created articular-surface rotator cuff tear. J Shoulder Elbow Surg 11(6):562–569CrossRefPubMedGoogle Scholar
  4. 4.
    Blevins FT, Djurasovic M, Flatow EL et al (1997) Biology of the rotator cuff tendon. Orthop Clin North Am 28(1): 1–16CrossRefPubMedGoogle Scholar
  5. 5.
    Bokor DJ, Hawkins RJ, Huckell GH, Angelo RL, Schickendantz MS (1993) Results of nonoperative management of full-thickness tears of the rotator cuff. Clin Orthop Relat Res 294:103–110PubMedGoogle Scholar
  6. 6.
    Brooks CH, Revell WJ, Heatley FW (1992) A quantitative histological study of the vascularity of the rotator cuff tendon. J Bone Joint Surg 74B(1):151–153Google Scholar
  7. 7.
    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 80:733–748PubMedGoogle Scholar
  8. 8.
    Clark JM, Harryman DT II (1992) Tendons ligaments, and capsule of the rotator cuff. J Bone Joint Surg 74A(5): 713–725Google Scholar
  9. 9.
    Conway JE (2001) Arthroscopic repair of partial-thickness rotator cuff tears and SLAP lesions in professional baseball players. Orthop Clin North Am 32:443–456CrossRefPubMedGoogle Scholar
  10. 10.
    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: 257–260PubMedGoogle Scholar
  11. 11.
    Ellman H (1990) Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop 254:64–74PubMedGoogle Scholar
  12. 12.
    Ferrari FS, Governi S, Burresi F, Vigni F, Stefani P (2002) Supraspinatus tendon tears: comparison of US and MR arthrography with surgical correlation. Eur Radiol 12: 1211–1217CrossRefPubMedGoogle Scholar
  13. 13.
    Fukuda H (2003) The management of partial – thickness tears of the rotator cuff. J Bone Joint Surg 85-B(1):2–11Google Scholar
  14. 14.
    Fukuda H, Craig EV, Yamanaka K (1987) Surgical treatment of incomplete thickness tears of rotator cuff: long-term follow-up. Orthop Trans 11:237–238Google Scholar
  15. 15.
    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 304:60–67PubMedGoogle Scholar
  16. 16.
    Fukuda H, Mikasa M, Ogawa K, Yamanaka K, Hamada K (1983) The partial thickness tear of the rotator cuff. Orthop Trans 7:137Google Scholar
  17. 17.
    Gartsman GM, Milne JC (1995) Articular surface partial-thickness rotator cuff tears. J Shoulder Elbow Surg 4: 409–415CrossRefPubMedGoogle Scholar
  18. 18.
    Gohlke F, Essigkrug B, Schmitz F (1994) The pattern of the collagen fiber bundles of the capsule of the glenohumeral joint. J Shoulder Elbow Surg 3:111–128CrossRefGoogle Scholar
  19. 19.
    Gotoh M, Hamada K, Yamakawa H, Inoue A, Fukuda H (1998) Increased substance P in subacromial bursa and shoulder pain in rotator cuff diseases. J Orthop Res 16:618–621CrossRefPubMedGoogle Scholar
  20. 20.
    Gulotta VL, Rodeo SA (2009) Growth factors for rotator cuff repair. Clin Sports Med 28:13–23CrossRefPubMedGoogle Scholar
  21. 21.
    Habermeyer P, Krieter C, Tang K, Lichtenberg S, Magosch P (2008) A new arthroscopic classification of articular-sided supraspinatus footprint lesions: a prospective comparison with Snyder’s and Ellman’s classification. J Shoulder Elbow Surg 17:909–913CrossRefPubMedGoogle Scholar
  22. 22.
    Hashimoto T, Nobuhara K, Hamada T (2003) Pathologic evidence of degeneration as a primary cause of rotator cuff tear. Clin Orthop Relat Res 415:111–120CrossRefPubMedGoogle Scholar
  23. 23.
    Hawkins RH, Dunlop R (1995) Nonoperative treatment of rotator cuff tears. Clin Orthop 321:178–188PubMedGoogle Scholar
  24. 24.
    Yadav H, Nho S, Romeo A, John MacGillivray D (2009) Rotator cuff tears: pathology and repair. Knee Surg Sports Traumatol Arthrosc 17:409–421CrossRefPubMedGoogle Scholar
  25. 25.
    Itoi E, Tabata S (1992) Conservative treatment of rotator cuff tears. Clin Orthop Relat Res 275:165–173PubMedGoogle Scholar
  26. 26.
    Itoi E, Tabata S (1992) Incomplete rotator cuff tears: results of operative treatment. Clin Orthop 284:128–135PubMedGoogle Scholar
  27. 27.
    Kassarjian A, Bencardino JT, Palmer WE (2006) MR imaging of the rotator cuff. Radiol Clin North Am 44:503–523, vii–viiiGoogle Scholar
  28. 28.
    Kelly BT, Williams RJ, Cordasco FA, Backus SI, Otis JC, Weiland DE, Altchek D, Craig EV, Wickiewicz T, Warren RF (2005) Differential patterns of muscle activation in patients with symptomatic and asymptomatic rotator cuff tears. J Shoulder Elbow Surg 14:165–171CrossRefPubMedGoogle Scholar
  29. 29.
    Kuhn JE (2009) Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence based rehabilitation protocol. J Shoulder Elbow Surg 18:138–160CrossRefPubMedGoogle Scholar
  30. 30.
    Langenderfer JE, Patthanacharoenphon C, Carpenter JE, Hughes RE (2006) Variation in external rotation moment arms among subregions of supraspinatus, infraspinatus, and teres minor muscles. J Orthop Res 24(8):1737–1744CrossRefPubMedGoogle Scholar
  31. 31.
    Lohr JF, Uhthoff HK (1990) The microvascular pattern of the supraspinatus tendon. Clin Orthop 254:35–38PubMedGoogle Scholar
  32. 32.
    Lomas G, Kippe MA, Brown GD, Gardner TR, Ding A, Levine WN, Ahmad CS (2008) In situ transtendon repair outperforms tear completion and repair for partial articular-sided supraspinatus tendon tears. J Shoulder Elbow Surg 17:722–728CrossRefGoogle Scholar
  33. 33.
    Malcarney HL, Murrell GAC (2003) The rotator cuff – biological adaptations to its environment. J Sports Med 33(13): 993–1002CrossRefGoogle Scholar
  34. 34.
    Matthew Matava J, Derek Purcell B, Jonas R (2005) Rudzki partial-thickness rotator cuff tears. Am J Sports Med 33: 1405–1417CrossRefPubMedGoogle Scholar
  35. 35.
    McConville OR, Ianotti JP (1999) Partial-thickness tears of the rotator cuff: evaluation and management. J Am Acad Orthop Surg 7:32–43PubMedGoogle Scholar
  36. 36.
    Mell AG, Lascalza S, Guffey P, Ray J, Maciejewski M, Carpenter JE, Hughes RE (2005) Effects of rotator cuff pathology on shoulder. Rhytm J Shoulder Elbow Surg 14: 58S–64SCrossRefGoogle Scholar
  37. 37.
    Moosmayer S, Smith J, Tariq R, Larmo A (2009) Prevalence and characteristics of asymptomatic tears of the rotator cuff. J Bone Joint Surg (Br) 91-B:196–200Google Scholar
  38. 38.
    Moseley HF, Goldie I (1963) The arterial pattern of the rotator cuff and the shoulder. J Bone Joint Surg 45B: 780–789Google Scholar
  39. 39.
    Olsewski JM, Depew AD (1994) Arthrscopic subacromial decompression and rotator cuff debridement for stage II and stage III impingement. Arthroscopy 10:61–68CrossRefPubMedGoogle Scholar
  40. 40.
    Park JY, Chung KT, Yoo MJ (2004) A serial comparison of arthroscopic repairs for partial- and full-thickness rotator cuff tears. Arthroscopy 20:705–711PubMedGoogle Scholar
  41. 41.
    Perry SM, Getz CL, Soslowsky LJ (2009) Alterations in function after rotator cuff tears in an animal model. J Shoulder Elbow Surg 18:296–304CrossRefPubMedGoogle Scholar
  42. 42.
    Porat S, Nottage WM, Fouse MN (2008) Repair of partial thickness rotator cuff tears: a retrospective review with minimum two-year follow-up. J Shoulder Elbow Surg 17:729–731CrossRefPubMedGoogle Scholar
  43. 43.
    Rathbun JB, Macnab I (1970) The microvascular pattern of the rotator cuff. J Bone Joint Surg 52B:540–553Google Scholar
  44. 44.
    Ruotolo C, Fow JE, Nottage WM (2004) The supraspinatus footprint: an anatomic study of the supraspinatus insertion. Arthroscopy 20(3):246–249CrossRefPubMedGoogle Scholar
  45. 45.
    Seitz WH, Froimson AI, Sordon TL (1991) A comparison of arthroscopic subacromial decompression for full thickness versus partial thickness rotator cuff tears. Paper #36, ASES Specialty Day, Anaheim, CA; MarchGoogle Scholar
  46. 46.
    Yang S, Park H, Flores S, Levin S, Makhsous M, Lin F, Koh J, Nuber G, Zhang L (2009) Biomechanical analysis of bursal-sided partial thickness rotator cuff tears. J Shoulder Elbow Surg 18:379–385CrossRefPubMedGoogle Scholar
  47. 47.
    Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB (1995) Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg [Am] 77-A: 10–15Google Scholar
  48. 48.
    Snyder SJ (ed) (2003) Arthroscopic classification of rotator cuff lesions and surgical decision making. In: Shoulder arthroscopy, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 201–207Google Scholar
  49. 49.
    Snyder SJ, Pachelli AF, Del Pizzo W, Friedman MJ, Ferkel RD, Pattee G (1991) Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy 7:1–7CrossRefPubMedGoogle Scholar
  50. 50.
    Soslowsky LJ, Carpenter JE, Bucchieri JS (1997) Biomechanics of the rotator cuff. Orthop Clin North Am 28(1):17–30CrossRefPubMedGoogle Scholar
  51. 51.
    Walch G, Boileau P, Noel E, Donell ST (1992) Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg 1:238–245CrossRefGoogle Scholar
  52. 52.
    Weber SC (1999) Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears. Arthroscopy 15:126–131CrossRefPubMedGoogle Scholar
  53. 53.
    Vlychou M, Dailiana Z, Fotiadou A, Papanagiotou M, Fezoulidis IV, Malizos KN (2009) Symptomatic partial rotator cuff tears: diagnostic performance of ultrasound and magnetic resonance imaging with surgical correlation. Acta Radiol 1:101–105CrossRefGoogle Scholar
  54. 54.
    Yamaguchi K, Tetro MA, Blam O, Evanoff BA, Teefey SA, Middleton WD (2001) Natural History of asymptomatic rotator cuff tears: a longitudinal analysis of asyntomatic tears detected sonographically. J Shoulder Elbow Surg 10(3):199–203CrossRefPubMedGoogle Scholar
  55. 55.
    Yamanaka K, Fukuda H (1987) Pathological studies of the supraspinatus tendon with reference to incomplete thickness tear. In: Takagishi N (ed) The shoulder. Professional postgraduate services, Tokyo, pp 220–224Google Scholar
  56. 56.
    Yamanaka K, Matsumoto T (1994) The joint side tear of the rotator cuff: a follow-up study by arthrography. Clin Orthop Relat Res 304:68–73PubMedGoogle Scholar
  57. 57.
    Zeitoun-Eiss D, Brasseur JL, Goldmard JL (2005) Corrélations entre la sémiologie échographique et la douleur dans les ruptures transfixiantes de la coiffe dês rotateurs. In: Blum A, Tavernier T, Brasseur JL et al (eds). Une approche pluridisciplinaire. Sauramps médical, Montpellier, p 287e94Google Scholar

Copyright information

© EFORT 2010

Authors and Affiliations

  1. 1.Hospital Cuf DescobertasLisbonPortugal

Personalised recommendations