Traumatic full-thickness transtendinous rotator cuff tears: a case series

• Published in: Journal of shoulder and elbow surgery 2017-01, Vol.26 (1), p.62-67
• Main Authors: Walcott, Marie E., MD, Daniels, Stephen D., BS, Sinz, Nathan J., BA, Field, Larry D., MD, Higgins, Laurence D., MD, MBA
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthroscopy - methods; case series; Female; full thickness; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Orthopedics; outcomes; Range of Motion, Articular; Retrospective Studies; Rotator Cuff Injuries - diagnostic imaging; Rotator Cuff Injuries - physiopathology; Rotator Cuff Injuries - surgery; rotator cuff repair; side-to-side repair; Suture Anchors; Transtendinous; traumatic rotator cuff tear; Treatment Outcome
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2016.04.023

Hypothesis Our purpose was to describe an arthroscopic repair technique for and outcomes of traumatic transtendinous rotator cuff tears affecting the supraspinatus tendon. Materials and methods A retrospective review was performed on a series of patients between January 2009 and January 2012. Demographic data, as well as preoperative and postoperative clinical data including strength, visual analog scale pain score, Subjective Shoulder Value, American Shoulder and Elbow Surgeons score, and Simple Shoulder Test score, were obtained. Results Seven patients were identified with magnetic resonance imaging showing full-thickness, transtendon supraspinatus tears with extension into the infraspinatus, which were consistent with physical examination and arthroscopic findings. The mechanism of injury was traumatic in all cases, usually a fall with the arm abducted. The mean remaining stump of tendon measured 1.3 cm. All patients underwent open or arthroscopic repair by a side-to-side (tendon-to-tendon) technique with additional suture anchor augmentation. At an average follow-up of 41.5 months (range, 33-50 months), all patients had postoperative improvements in strength and visual analog scale pain scores (range, 0-1), as well as Subjective Shoulder Value, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores greater than 90. Conclusion We have described the occurrence of a rare rotator cuff tear in the purely tendinous portion of the muscle, leaving at least 1 cm of tendon attached to an intact footprint. We also have presented an arthroscopic side-to-side repair technique and postoperative outcomes. To our knowledge, this is the first article describing this uncommon rotator cuff tear.