Editorial Commentary: Arthroscopic Repair of Partial-Thickness Rotator Cuff Tears Shows Long-Term Clinically Significant Improved Outcomes.

Abstract

Management of partial-thickness rotator cuff tears (PTRCTs) remains controversial, particularly regarding optimal timing of intervention, surgical technique, and prognostic indicators. There are 3 PTRCT subtypes: articular, bursal, and intrasubstance. The accurate assessment of the percentage thickness of PTRCTs can be challenging; symptomatic PTRCTs that appear relatively innocuous on magnetic resonance imaging can often appear much larger and involve a significantly greater depth of the tendon attachment when viewed arthroscopically, particularly after gentle debridement of pathologic tendon. For articular-sided lesions, remaining tendon quality and thickness can be gauged by probing with a needle from the bursal surface, tagging can be performed with a monofilament suture to show the location of the tear from the intact bursal surface, and full-thickness arthroscopic double-row repair is recommended. Intrasubstance tears are more difficult to assess, and the sliding sensation and saline solution injection "bubble sign" tests may confirm and locate these tear types. Intrasubstance tears may be converted to bursal-sided tears and treated as such.