The Journal of Bone and Joint Surgery (American). 2009;91:1055-1062.
doi:10.2106/JBJS.G.00118
© 2009 The Journal of Bone and Joint Surgery, Inc.
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 Shoulder/Elbow Test 27: Summer 2009 (publication date August 14, 2009; expi...
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Tendon Integrity and Functional Outcome After Arthroscopic Repair of High-Grade Partial-Thickness Supraspinatus Tears

Ganesh Kamath, MD1, Leesa M. Galatz, MD1, Jay D. Keener, MD1, Sharlene Teefey, MD2, William Middleton, MD2 and Ken Yamaguchi, MD1

1 Shoulder and Elbow Service, Department of Orthopaedic Surgery, Washington University, Campus Box 8233, 660 South Euclid Avenue, St. Louis, MO 63110. E-mail address for L.M. Galatz: galatzl{at}wustl.edu
2 Mallinckrodt Institute of Radiology, 510 South Kingshighway Boulevard, St. Louis, MO 63110

Investigation performed at the Shoulder and Elbow Service, Washington University Orthopaedics, Barnes-Jewish Hospital, St. Louis, Missouri

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits of less than $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Arthrex). Also, a commercial entity (Arthrex) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated.

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM/DVD (call our subscription department, at 781-449-9780, to order the CD-ROM or DVD).

Background: Partial-thickness rotator cuff tears are a common cause of shoulder pain, yet the appropriate surgical treatment is controversial. In particular, very little information is available regarding rotator cuff integrity after operative repair. The purpose of this study was to evaluate the functional outcome and anatomic healing rate after arthroscopic repair of high-grade partial (>50%) thickness tears of the supraspinatus tendon.

Methods: Forty-one consecutive patients (forty-two shoulders) who had undergone arthroscopic conversion of a partial-thickness rotator cuff tear to a full-thickness tear and subsequent repair were evaluated with ultrasound for evidence of rotator cuff healing. Clinical outcomes were assessed with use of validated outcomes measures, and all patients were reexamined by an independent observer.

Results: The average patient age was fifty-three years. Thirty-seven (88%) of the forty-two shoulders had an intact rotator cuff repair seen on ultrasound at an average of eleven months postoperatively. The remaining five patients had a full-thickness defect in the tendon. The mean American Shoulder and Elbow Surgeons (ASES) score improved from 46.1 points preoperatively to 82.1 points at the time of follow-up. The overall rate of patient satisfaction was 93%. The average age of the patients with an intact rotator cuff was 51.8 years compared with 62.6 years for those with a persistent defect (p = 0.02).

Conclusions: Arthroscopic repair of high-grade partial-thickness rotator cuff tears results in a high rate of tendon healing. Patient age is an important factor in tendon healing.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


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Letters to the Editor:

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Association of Partial Thickness Tears of the Rotator Cuff and Shoulder Pain
Joseph Bernstein
JBJS Online, 10 Jun 2009 [Full text]
Dr. Galatz and colleagues respond to Dr. Bernstein
Leesa M. Galatz, MD, et al.
JBJS Online, 10 Jun 2009 [Full text]