To evaluate return to sport, clinical outcomes, and complications in a series of athletes with painful partial-thickness rotator cuff tears treated with the arthroscopic in situ repair with a minimum 2-year follow-up.
Retrospective case series. Seventy-two patients who had undergone an arthroscopic in situ repair for partial-thickness rotator cuff tears were evaluated. We assessed return to sport and the level achieved after surgery. Clinical assessment consisted of glenohumeral range of motion measurement and the American Shoulder and Elbow Surgeons score. Pain was recorded using a visual analog scale. Postoperative complications were also assessed.
The mean age was 42.2 years (range, 21-66 years), and the mean follow-up was 54 months (range, 24-113 months). Sixty-one patients (87%) were able to return to sports. Fifty-six patients (80%) returned to the same level they had previous to the injury. The mean interval between surgery and return to competition was 5.6 months. The final functional outcomes were related neither to the type of sports nor to the level of competition before the injury. All active range of motion parameters improved significantly (P < .0001). The American Shoulder and Elbow Surgeons score improved from 43.3 to 88.1, and the visual analog scale scores improved from 6.1 to 1.2 (P < .0001). No significant difference regarding return to sports or functional outcomes was found between articular and bursal-sided tears. Only 5 patients developed a postoperative adhesive capsulitis that responded to physical therapy.
In patients with partial-thickness rotator cuff tears, arthroscopic in situ repair resulted in excellent functional outcomes, with most of the patients returning to sport and at the same level they had before injury. The results were equally favorable in articular and bursal tears.
Level of Evidence
Level IV, therapeutic case series.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Arthroscopy
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Partial-thickness rotator cuff tears.J Shoulder Elbow Surg. 2010; 19: 609-616
- Partial thickness rotator cuff tears: Current concepts.Adv Orthop. 2015; 2015: 458786
- Arthroscopic repair of partial-thickness tears of the rotator cuff.J Shoulder Elbow Surg. 2007; 16: 193-201
- Tendon integrity and functional outcome after arthroscopic repair of high-grade partial-thickness supraspinatus tears.J Bone Joint Surg Am. 2009; 91: 1055-1062
- Repair integrity and functional outcome after arthroscopic conversion to a full- thickness rotator cuff tear: Articular- versus bursal-side partial tears.Am J Sports Med. 2014; 42: 451-456
- Magnetic resonance imaging tendon integrity assessment after arthroscopic partial-thickness rotator cuff repair.Arthroscopy. 2011; 27: 306-313
- Transtendon arthroscopic repair of partial-thickness, articular surface tears of the rotator cuff.Arthroscopy. 2004; 20: 214-220
- Arthroscopic intratendinous repair of the delaminated partial-thickness rotator cuff tear in overhead athletes.Arthroscopy. 2008; 24: 961-965
- Predictive factors of subtle residual shoulder symptoms after transtendinous arthroscopic cuff repair: A clinical study.Am J Sports Med. 2009; 37: 103-108
- Arthroscopic in situ repair of partial bursal rotator cuff tears without acromioplasty.Arthroscopy. 2017; 33: 1294-1298
- Arthroscopic transtendon repair of partial-thickness articular-side rotator cuff tears.Arthroscopy. 2016; 32: 1523-1528
- Clinical and magnetic resonance imaging results of arthroscopic full-layer repair of bursal-side partial thickness rotator cuff tears.Am J Sports Med. 2011; 39: 1660-1667
- Clinical and structural results of arthroscopic repair of bursal-side partial-thickness rotator cuff tears.J Shoulder Elbow Surg. 2015; 24: e41-e46
- Articular-sided rotator cuff tears: Which is the best repair? A three-year prospective randomised controlled trial.Int Orthop. 2013; 37: 1487-1493
- Deep partial rotator cuff tear: Transtendon repair or tear completion and repair? A randomized clinical trial.Knee Surg Sports Traumatol Arthrosc. 2015; 23: 460-463
- Clinical outcomes of modified Mason-Allen single-row repair for bursal-sided partial-thickness rotator cuff tears: Comparison with the double-row suture-bridge technique.Am J Sports Med. 2015; 43: 1976-1982
- Which is the best repair of articular-sided rotator cuff tears: A meta-analysis.J Orthop Surg Res. 2015; 10: 84
- Shoulder sport-specific impairments after arthroscopic Bankart repair: A prospective longitudinal assessment.Am J Sports Med. 2011; 39: 2404-2414
- Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder.J Bone Joint Surg Am. 1998; 80: 841-852
- Rotator cuff healing and the bone marrow “crimson duvet” from clinical observations to science.Tech Shoulder Elbow Surg. 2009; 10: 130-137
- Repair of partial-thickness rotator cuff tears: A biomechanical analysis of footprint contact pressure and strength in an ovine model.Arthroscopy. 2010 Jul; 26: 877-884
- In situ transtendon repair outperforms tear completion and repair for partial articular-sided supraspinatus tendon tears.J Shoulder Elbow Surg. 2008; 17: 722-728
- Return to sport after rotator cuff tear repair: A systematic review and meta-analysis.Am J Sports Med. 2016; 44: 1877-1887
- Rotator cuff repair in adolescent athletes.Am J Sports Med. 2018; 46: 1084-1090
- Treatment of partial thickness rotator cuff tears in overhead athletes.Curr Rev Musculoskelet Med. 2018; 11: 55-62
- Arthroscopic management of full-thickness rotator cuff tears in Major League Baseball pitchers: The lateralized footprint repair technique.Am J Orthop (Belle Mead, NJ). 2015; 45: 128-133
- Repair of full-thickness rotator cuff tears in professional baseball players.Am J Sports Med. 2006; 34: 182-189
Published online: November 22, 2018
Accepted: July 13, 2018
Received: March 9, 2018
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
This study was approved by the Ethical Committee of the Italian Hospital of Buenos Aires.
© 2018 by the Arthroscopy Association of North America