Mid-term effectiveness of arthroscopic “mini incision” transtendon repair for partial articular-sided supraspinatus tendon avulsion lesion_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANG Peiguan ,  WANG Bei , TAN Guanghua , WANG Xiaoxu , QIU Mingjun , YAN Huyong

The Second Affiliated Hospital, Department of Joint Surgery, Hengyang Medical School, University of South China, 421000, P. R. China;

Corresponding?author：

WANG Bei, Email: 1369428720@qq.com

Keywords：

Rotator cuff injury; partial articular-sided supraspinatus tendon avulsion; arthroscopy; transtendon repair; mid-term effectiveness

DOI：

10.7507/1002-1892.202303047

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Objective To explore the mid-term effectiveness of arthroscopic “mini incision” transtendon repair for partial articular-sided supraspinatus tendon avulsion (PASTA) lesion. Methods A clinical data of 39 patients with PASTA lesions, who underwent the arthroscopic “mini incision” transtendon repair and met the selected criteria between May 2017 and April 2021, was retrospectively analyzed. There were 13 males and 26 females, with an average age of 63.7 years (range, 43-76 years). Nine patients underwent trauma history, and no obvious inducement was found in the other 30 patients. The main clinical symptom was shoulder pain with positive hug resistance test. The interval from symptom onset to operation was 3-21 months (mean, 8.3 months). The visual analogue scale (VAS) score, University of California Los Angeles (UCLA) shoulder score, American Association of Shoulder and Elbow Surgeons (ASES) score and shoulder range of motion (ROM) of forward flexion, abduction, and external rotation were used to evaluate shoulder function. MRI was performed to assess the structural integrity and tension of reattached tendon. Patient satisfactions were calculated at last follow-up. Results All incisions healed by first intention with no complications such as incision infection or nerve injury. All patients were followed up 24-71 months (mean, 46.9 months). The VAS, UCLA, and ASES scores significantly improved at 24 months after operation when compared with preoperative ones (P<0.05). The ROMs of forward flexion and external rotation of the shoulder joint significantly increased at 3 and 24 months, and further increased at 24 months compared to 3 months, with significant differences (P<0.05). However, the ROM of abduction of the shoulder joint at 3 months did not significantly improve compared with that before operation (P>0.05), and it was significantly greater at 24 months than before operation and at 3 months after operation (P<0.05). At last follow-up, the patients were very satisfied with the effectiveness in 30 cases (76.9%), satisfied in 5 cases (12.8%), and dissatisfied in 4 cases (10.3%). At 6 months after operation, 31 patients underwent reviews of MRI scans, of which 28 patients possessed intact structural integrity, good tendon tension and tendon healing, and 3 patients underwent tendon re-tear. Conclusion Arthroscopic “mini incision” transtendon repair in treatment of PASTA lesion could obtain satisfying mid-term effectiveness with low risk of tendon re-tear.

Citation： HUANG Peiguan, WANG Bei, TAN Guanghua, WANG Xiaoxu, QIU Mingjun, YAN Huyong. Mid-term effectiveness of arthroscopic “mini incision” transtendon repair for partial articular-sided supraspinatus tendon avulsion lesion. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(6): 653-657. doi: 10.7507/1002-1892.202303047 Copy

1.	Kim YS, Kim SE, Bae SH, et al. Tear progression of symptomatic full-thickness and partial-thickness rotator cuff tears as measured by repeated MRI. Knee Surg Sports Traumatol Arthrosc, 2017, 25(7): 2073-2080.
2.	汪滋民, 李全, 王一, 等. 關節鏡下經肌腱修補治療關節側肩袖部分損傷. 中華肩肘外科電子雜志, 2014, 2(1): 16-22.
3.	Kamath G, Galatz LM, Keener JD, et al. Tendon integrity and functional outcome after arthroscopic repair of high-grade partial-thickness supraspinatus tears. J Bone Joint Surg (Am), 2009, 91(5): 1055-1062.
4.	Duralde XA, McClelland WB. The clinical results of arthroscopic transtendinous repair of grade Ⅲ partial articular-sided supraspinatus tendon tears. Arthroscopy, 2012, 28(2): 160-168.
5.	Vinanti GB, Rossato A, Scrimieri D, et al. Arthroscopic transtendon repair of partial articular-sided supraspinatus tendon avulsion. Knee Surg Sports Traumatol Arthrosc, 2017, 25(7): 2151-2156.
6.	Aydin N, Karaismailoglu B. High-grade bursal-side partial rotator cuff tears: comparison of mid- and long-term results following arthroscopic repair after conversion to a full-thickness tear. J Orthop Surg Res, 2017, 12(1): 118. doi: 10.1186/s13018-017-0619-7.
7.	Shin SJ. A comparison of 2 repair techniques for partial-thickness articular-sided rotator cuff tears. Arthroscopy, 2012, 28(1): 25-33.
8.	Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res, 1990, (254): 64-74.
9.	Donohue NK, Nickel BT, Grindel SI. High-grade articular, bursal, and intratendinous partial-thickness rotator cuff tears: a retrospective study comparing functional outcomes after completion and repair. Am J Orthop (Belle Mead NJ), 2016, 45(5): E254-E60.
10.	Waibl B, Buess E. Partial-thickness articular surface supraspinatus tears: a new transtendon suture technique. Arthroscopy, 2005, 21(3): 376-381.
11.	Stuart KD, Karzel RP, Ganjianpour M, et al. Long-term outcome for arthroscopic repair of partial articular-sided supraspinatus tendon avulsion. Arthroscopy, 2013, 29(5): 818-823.
12.	Gonzalez-Lomas G, Kippe MA, Brown GD, et al. In situ transtendon repair outperforms tear completion and repair for partial articular-sided supraspinatus tendon tears. J Shoulder Elbow Surg, 2008, 17(5): 722-728.
13.	Franceschi F, Papalia R, Del Buono A, et al. Articular-sided rotator cuff tears: which is the best repair? A three-year prospective randomised controlled trial. Int Orthop, 2013, 37(8): 1487-1493.
14.	Woods TC, Carroll MJ, Nelson AA, et al. Transtendon rotator-cuff repair of partial-thickness articular surface tears can lead to medial rotator-cuff failure. Open Access J Sports Med, 2014, 5: 151-157.
15.	Zhang QS, Liu S, Zhang Q, et al. Comparison of the tendon damage caused by four different anchor systems used in transtendon rotator cuff repair. Adv Orthop, 2012, 2012: 798521. doi: 10.1155/2012/798521.
16.	Peters KS, Lam PH, Murrell GA. Repair of partial-thickness rotator cuff tears: a biomechanical analysis of footprint contact pressure and strength in an ovine model. Arthroscopy, 2010, 26(7): 877-884.
17.	Huang CY, Wang VM, Pawluk RJ, et al. Inhomogeneous mechanical behavior of the human supraspinatus tendon under uniaxial loading. J Orthop Res, 2005, 23(4): 924-930.
18.	Huberty DP, Schoolfield JD, Brady PC, et al. Incidence and treatment of postoperative stiffness following arthroscopic rotator cuff repair. Arthroscopy, 2009, 25(8): 880-890.
19.	Matava MJ, Purcell DB, Rudzki JR. Partial-thickness rotator cuff tears. Am J Sports Med, 2005, 33(9): 1405-1417.

1. Kim YS, Kim SE, Bae SH, et al. Tear progression of symptomatic full-thickness and partial-thickness rotator cuff tears as measured by repeated MRI. Knee Surg Sports Traumatol Arthrosc, 2017, 25(7): 2073-2080.
2. 汪滋民, 李全, 王一, 等. 關節鏡下經肌腱修補治療關節側肩袖部分損傷. 中華肩肘外科電子雜志, 2014, 2(1): 16-22.
3. Kamath G, Galatz LM, Keener JD, et al. Tendon integrity and functional outcome after arthroscopic repair of high-grade partial-thickness supraspinatus tears. J Bone Joint Surg (Am), 2009, 91(5): 1055-1062.
4. Duralde XA, McClelland WB. The clinical results of arthroscopic transtendinous repair of grade Ⅲ partial articular-sided supraspinatus tendon tears. Arthroscopy, 2012, 28(2): 160-168.
5. Vinanti GB, Rossato A, Scrimieri D, et al. Arthroscopic transtendon repair of partial articular-sided supraspinatus tendon avulsion. Knee Surg Sports Traumatol Arthrosc, 2017, 25(7): 2151-2156.
6. Aydin N, Karaismailoglu B. High-grade bursal-side partial rotator cuff tears: comparison of mid- and long-term results following arthroscopic repair after conversion to a full-thickness tear. J Orthop Surg Res, 2017, 12(1): 118. doi: 10.1186/s13018-017-0619-7.
7. Shin SJ. A comparison of 2 repair techniques for partial-thickness articular-sided rotator cuff tears. Arthroscopy, 2012, 28(1): 25-33.
8. Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res, 1990, (254): 64-74.
9. Donohue NK, Nickel BT, Grindel SI. High-grade articular, bursal, and intratendinous partial-thickness rotator cuff tears: a retrospective study comparing functional outcomes after completion and repair. Am J Orthop (Belle Mead NJ), 2016, 45(5): E254-E60.
10. Waibl B, Buess E. Partial-thickness articular surface supraspinatus tears: a new transtendon suture technique. Arthroscopy, 2005, 21(3): 376-381.
11. Stuart KD, Karzel RP, Ganjianpour M, et al. Long-term outcome for arthroscopic repair of partial articular-sided supraspinatus tendon avulsion. Arthroscopy, 2013, 29(5): 818-823.
12. Gonzalez-Lomas G, Kippe MA, Brown GD, et al. In situ transtendon repair outperforms tear completion and repair for partial articular-sided supraspinatus tendon tears. J Shoulder Elbow Surg, 2008, 17(5): 722-728.
13. Franceschi F, Papalia R, Del Buono A, et al. Articular-sided rotator cuff tears: which is the best repair? A three-year prospective randomised controlled trial. Int Orthop, 2013, 37(8): 1487-1493.
14. Woods TC, Carroll MJ, Nelson AA, et al. Transtendon rotator-cuff repair of partial-thickness articular surface tears can lead to medial rotator-cuff failure. Open Access J Sports Med, 2014, 5: 151-157.
15. Zhang QS, Liu S, Zhang Q, et al. Comparison of the tendon damage caused by four different anchor systems used in transtendon rotator cuff repair. Adv Orthop, 2012, 2012: 798521. doi: 10.1155/2012/798521.
16. Peters KS, Lam PH, Murrell GA. Repair of partial-thickness rotator cuff tears: a biomechanical analysis of footprint contact pressure and strength in an ovine model. Arthroscopy, 2010, 26(7): 877-884.
17. Huang CY, Wang VM, Pawluk RJ, et al. Inhomogeneous mechanical behavior of the human supraspinatus tendon under uniaxial loading. J Orthop Res, 2005, 23(4): 924-930.
18. Huberty DP, Schoolfield JD, Brady PC, et al. Incidence and treatment of postoperative stiffness following arthroscopic rotator cuff repair. Arthroscopy, 2009, 25(8): 880-890.
19. Matava MJ, Purcell DB, Rudzki JR. Partial-thickness rotator cuff tears. Am J Sports Med, 2005, 33(9): 1405-1417.

Chinese Journal of Reparative and Reconstructive Surgery

Mid-term effectiveness of arthroscopic “mini incision” transtendon repair for partial articular-sided supraspinatus tendon avulsion lesion

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