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Partial-Thickness Rotator Cuff Tears

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Shoulder Arthroscopy

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Abstract

Rotator cuff pathology is extremely common and can be a significant cause of shoulder pain and functional limitations. Injuries include a spectrum of disease from partial-thickness tears to full-thickness massive tears. Although frequently asymptomatic, partial-thickness rotator cuff tears can become increasingly painful and functionally limiting with cumulative injuries and increasing age. Although many of these can be managed conservatively, a substantial number of partial-thickness tears will progress to requiring surgery, the technique for which is often dictated by the location and thickness of the tear. This chapter will provide a brief overview of the epidemiology and pathoanatomy of partial-thickness tears, followed by a step-by-step review of the clinical decision-making process including patient history, physical exam, imaging, and discussion of surgical techniques and indications, and lastly, a brief overview of clinical outcomes based on tear location and characteristics.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Colorado, Aurora, CO, USA

    Brady T. Williams

  2. OrthoConnecticut, The Sports Medicine Center, Danbury, CT, USA

    Theodore S. Wolfson

  3. Rush University Medical Center, Chicago, IL, USA

    Amar Vadhera & Nikhil N. Verma

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  1. Brady T. Williams
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  2. Theodore S. Wolfson
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  3. Amar Vadhera
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  4. Nikhil N. Verma
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Correspondence to Nikhil N. Verma .

Editor information

Editors and Affiliations

  1. Department of Joint and Bone Surgery, University of Brescia, Brescia, Brescia, Italy

    Giuseppe Milano

  2. Department of Orthopaedics and Traumatology, Casa di Cura Villa Valeria, Rome, Roma, Italy

    Andrea Grasso

  3. Shoulder and Upper Limb Department, St. Luke's Hospital, Bielsko-Biała, Poland

    Roman Brzóska

  4. Department of Traumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Ladislav Kovačič

35.1 Electronic Supplementary Material

Arthroscopic video of a left shoulder demonstrating a high-grade partial-thickness articular-sided tear of the supraspinatus. Examination of the undersurface of the rotator cuff from within the joint demonstrates a high-grade articular-sided tear of the supraspinatus (0:00). Attention is then turned to the subacromial space. Following debridement and a thorough bursectomy, the bursal surface of the rotator cuff is interrogated and penetrated with an arthroscopic probe (0:12). An 11-blade is introduced through the lateral portal and used to complete the tear. The completed tear is debrided, and the tuberosity is prepared with a bone-cutting shaver (0:45). A single double-loaded suture anchor is placed centrally within the completed tear, approximately 5-mm lateral to the articular margin (1:10). A combination of a tissue penetrator and suture passing device are then used to complete the medial row of the repair (1:23). Two lateral anchors are then subsequently used to complete the double-row transosseous equivalent repair, placed approximately 5 mm from the lateral edge of the tuberosity (2:24) (MP4 151201 kb)

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Williams, B.T., Wolfson, T.S., Vadhera, A., Verma, N.N. (2023). Partial-Thickness Rotator Cuff Tears. In: Milano, G., Grasso, A., Brzóska, R., Kovačič, L. (eds) Shoulder Arthroscopy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-66868-9_35

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