Partial-thickness rotator cuff tears: a systematic review

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Partial-thickness tears of the rotator cuff (RC) of the shoulder joint (SJ) are a common condition that causes pain and limits SJ function, significantly reducing quality of life. The prevalence of such tears reaches up to 32% among SJ injuries and disorders. Among all isolated RC tendon injuries, supraspinatus tendon lesions are predominant, accounting for up to 13%. This work aimed to conduct a systematic review of research assessing radiographic parameters of SJ bone anatomy as risk factors for RC injury, as well as the outcomes of surgical treatment for partial-thickness RC tears. A search was conducted in the eLIBRARY, PubMed, and Scopus databases. The search depth was 10 years (2013–2023). The inclusion criteria for the quantitative analysis were a mean follow-up duration of at least 6 months and a minimum of 10 cases per study. Following a keyword-based screening, 18 publications were included in the quantitative analysis. The most significant radiographic risk factors for RC tears included the critical shoulder angle (CSA), lateral acromial angle (LAA), and acromial index (AI). Two principal surgical techniques for managing Ellman grade III partial-thickness RC tears were identified: tear completion and transtendinous tendon repair. Both techniques yielded satisfactory outcomes; however, it remains unclear which method should be preferred. Although the majority of studies report a direct association between CSA and RC injury, this parameter requires further investigation, as angular values obtained from radiographs without adherence to the Suter–Henninger protocol may differ significantly from those obtained in accordance with the protocol, as well as from CT or MRI findings. The majority of publications did not consider parameters like LAA and AI to be key predictors of RC injury. The analyzed outcomes of surgical treatment for partial-thickness RC tears showed no significant differences despite the use of different surgical techniques, such as tear completion and transtendinous tendon repair. However, this issue requires further investigation, including subsequent assessment of tendon healing quality based on MRI findings.

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作者简介

Artem Avdeev

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

编辑信件的主要联系方式.
Email: avdeev.artiom@mail.ru
ORCID iD: 0009-0008-9147-5808
SPIN 代码: 3852-2953

MD

俄罗斯联邦, 17 Frunze st, Novosibirsk, 630091

Anton Gofer

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

Email: a.hofer.ortho@gmail.com
ORCID iD: 0009-0000-3886-163X
SPIN 代码: 7085-8861

MD

俄罗斯联邦, 17 Frunze st, Novosibirsk, 630091

Aleksandr Alekperov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

Email: alecperov@mail.ru
ORCID iD: 0000-0003-3264-8146
SPIN 代码: 3819-0982

MD

俄罗斯联邦, 17 Frunze st, Novosibirsk, 630091

Dmitriy Rubtsov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

Email: rubic.dv@yandex.ru
ORCID iD: 0009-0007-1490-9783
SPIN 代码: 2863-2017

MD

俄罗斯联邦, 17 Frunze st, Novosibirsk, 630091

Vitaliy Pavlov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

Email: rubic.dv@yandex.ru
ORCID iD: 0000-0002-8997-7330
SPIN 代码: 7596-2960

MD, Dr. Sci. (Medicine)

俄罗斯联邦, 17 Frunze st, Novosibirsk, 630091

参考

  1. Fukuda H. Partial-thickness rotator cuff tears: a modern view on Codman’s classic. J Shoulder Elbow Surg. 2000;9(2):163–8.
  2. Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am. 1995;77(1):10–5. doi: 10.2106/00004623-199501000-00002
  3. Yamanaka K. Pathological study of the supraspinatus tendon. Nihon Seikeigeka Gakkai Zasshi. 1988;62(12):1121–38. (in Japanese).
  4. Kamijo H, Sugaya H, Takahashi N, et al. Arthroscopic Repair of Isolated Subscapularis Tears Show Clinical and Structural Outcome Better for Small Tears Than Larger Tears. Arthrosc Sports Med Rehabil. 2022 May;4(3):e1133–e1139. doi: 10.1016/j.asmr.2022.04.006
  5. Melis B, DeFranco MJ, Lädermann A, Barthelemy R, Walch G. The teres minor muscle in rotator cuff tendon tears. Skeletal Radiol. 2011;40(10):1335–44. doi: 10.1007/s00256-011-1178-3
  6. Fitzpatrick S, Reynolds AW, Purnell G. Arthroscopic Repair of an Isolated Infraspinatus Tear in a Contact Athlete: A Case Report. J Orthop Case Rep. 2019;9(3):7–10. doi: 10.13107/jocr.2250-0685.1394
  7. Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res. 1990;(254):64–74.
  8. Snyder SJ, Pachelli AF, Del Pizzo W, et al. Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy. 1991;7(1):1–7. doi: 10.1016/0749-8063(91)90070-e
  9. Zhao J, Luo M, Liang G, et al. What Factors Are Associated with Symptomatic Rotator Cuff Tears: A Meta-analysis. Clin Orthop Relat Res. 2022;480(1):96–105. doi: 10.1097/CORR.0000000000001949
  10. Ayanoglu T, Ozer M, Cetinkaya M, et al. Does Preoperative Conservative Management Affect the Success of Arthroscopic Repair of Partial Rotator Cuff Tear? Indian J Orthop. 2021;56(2):289–294. doi: 10.1007/s43465-021-00479-2
  11. Matthewson G, Beach CJ, Nelson AA, et al. Partial Thickness Rotator Cuff Tears: Current Concepts. Adv Orthop. 2015;2015:458786. doi: 10.1155/2015/458786
  12. Thangarajah T, Lo IK. Optimal Management of Partial Thickness Rotator Cuff Tears: Clinical Considerations and Practical Management. Orthop Res Rev. 2022;14:59–70. doi: 10.2147/ORR.S348726
  13. Brockmeyer M, Haupert A, Lausch AL, et al. Outcomes and Tendon Integrity After Arthroscopic Treatment for Articular-Sided Partial-Thickness Tears of the Supraspinatus Tendon: Results at Minimum 2-Year Follow-Up. Orthop J Sports Med. 2021;9(2):2325967120985106. doi: 10.1177/2325967120985106
  14. Leong YC, Yeoh CW, Azman MI, Juhari MS, Siti HT. Acromion Morphology of Patients with Rotator Cuff Disease in Standard AP Shoulder Radiograph in Hospital Sultanah Bahiyah and Hospital Kuala Lumpur. Malays Orthop J. 2022;16(3):50–54. doi: 10.5704/MOJ.2211.009
  15. Kim MS, Rhee SM, Jeon HJ, Rhee YG. Anteroposterior and Lateral Coverage of the Acromion: Prediction of the Rotator Cuff Tear and Tear Size. Clin Orthop Surg. 2022;14(4):593–602. doi: 10.4055/cios22073
  16. Hsu TH, Lin CL, Wu CW, et al. Accuracy of Critical Shoulder Angle and Acromial Index for Predicting Supraspinatus Tendinopathy. Diagnostics (Basel). 2022;12(2):283. doi: 10.3390/diagnostics12020283
  17. Yoo JS, Heo K, Yang JH, Seo JB. Greater tuberosity angle and critical shoulder angle according to the delamination patterns of rotator cuff tear. J Orthop. 2019;16(5):354–358. Erratum in: J Orthop. 2020;24:293. doi: 10.1016/j.jor.2019.03.015
  18. Logvinov AN, Il’in DO, Kadantsev PM, et al. Radiographic characteristics of the acromion process as a predictive factor of partial rotator cuff tears. Orthopaedic Genius. 2019;25(1):71–78. doi: 10.18019/1028-4427-2019-25-1-71-78 EDN: VXOZHH
  19. Liu CT, Miao JQ, Wang H, et al. The association between acromial anatomy and articular-sided partial thickness of rotator cuff tears. BMC Musculoskelet Disord. 2021;22(1):760. doi: 10.1186/s12891-021-04639-1
  20. Borbas P, Hartmann R, Ehrmann C, et al. Acromial Morphology and Its Relation to the Glenoid Is Associated with Different Partial Rotator Cuff Tear Patterns. J Clin Med. 2022;12(1):233. doi: 10.3390/jcm12010233
  21. Paim AE. In situ repair of partial articular surface lesions of the supraspinatus tendon. Rev Bras Ortop. 2017;52(3):303–308. doi: 10.1016/j.rboe.2017.04.004
  22. Franceschetti E, Giovannetti de Sanctis E, Palumbo A, et al. Lateral Acromioplasty has a Positive Impact on Rotator Cuff Repair in Patients with a Critical Shoulder Angle Greater than 35 Degrees. J Clin Med. 2020;9(12):3950. doi: 10.3390/jcm9123950
  23. Björnsson Hallgren HC, Adolfsson L. Neither critical shoulder angle nor acromion index were related with specific pathology 20 years later! Knee Surg Sports Traumatol Arthrosc. 2021;29(8):2648–2655. doi: 10.1007/s00167-021-06602-y
  24. Chen JJ, Ye Z, Liang JW, Xu YJ. Arthroscopic repair of partial articular supraspinatus tendon avulsion lesions by conversion to full-thickness tears through a small incision. Chin J Traumatol. 2020;23(6):336–340. doi: 10.1016/j.cjtee.2020.07.002
  25. Liu J, Dai S, Deng H, et al. Evaluation of the prognostic value of the anatomical characteristics of the bony structures in the shoulder in bursal-sided partial-thickness rotator cuff tears. Front Public Health. 2023;11:1189003. doi: 10.3389/fpubh.2023.1189003
  26. Melean P, Lichtenberg S, Montoya F, et al. The acromial index is not predictive for failed rotator cuff repair. Int Orthop. 2013;37(11):2173–9. doi: 10.1007/s00264-013-1963-9
  27. Chalmers PN, Salazar D, Steger-May K, et al. Does the Critical Shoulder Angle Correlate with Rotator Cuff Tear Progression? Clin Orthop Relat Res. 2017;475(6):1608–1617. doi: 10.1007/s11999-017-5249-1
  28. Gürpınar T, Polat B, Çarkçı E, et al. The Effect of Critical Shoulder Angle on Clinical Scores and Retear Risk After Rotator Cuff Tendon Repair at Short-term Follow Up. Sci Rep. 2019;9(1):12315. doi: 10.1038/s41598-019-48644-w
  29. Kanatli U, Ayanoğlu T, Ataoğlu MB, et al. Midterm outcomes after arthroscopic repair of partial rotator cuff tears: A retrospective study of correlation between partial tear types and surgical technique. Acta Orthop Traumatol Turc. 2020;54(2):196–201. doi: 10.5152/j.aott.2020.02.486
  30. Kocher MS, Horan MP, Briggs KK, et al. Reliability, validity, and responsiveness of the American Shoulder and Elbow Surgeons subjective shoulder scale in patients with shoulder instability, rotator cuff disease, and glenohumeral arthritis. J Bone Joint Surg Am. 2005;87(9):2006–11. doi: 10.2106/JBJS.C.01624
  31. Goldhahn J, Angst F, Drerup S, et al. Lessons learned during the cross-cultural adaptation of the American Shoulder and Elbow Surgeons shoulder form into German. J Shoulder Elbow Surg. 2008;17(2):248–54. doi: 10.1016/j.jse.2007.06.027
  32. Lohr JF, Uhthoff HK. The microvascular pattern of the supraspinatus tendon. Clin Orthop Relat Res. 1990;(254):35–8.
  33. Sano H, Ishii H, Trudel G, Uhthoff HK. Histologic evidence of degeneration at the insertion of 3 rotator cuff tendons: a comparative study with human cadaveric shoulders. J Shoulder Elbow Surg. 1999;8(6):574–9. doi: 10.1016/s1058-2746(99)90092-7
  34. Walch G, Boileau P, Noel E, Donell ST. Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: An arthroscopic study. J Shoulder Elbow Surg. 1992;1(5):238–45. doi: 10.1016/S1058-2746(09)80065-7
  35. Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder. 1972. J Bone Joint Surg Am. 2005;87(6):1399. doi: 10.2106/JBJS.8706.cl
  36. Moor BK, Bouaicha S, Rothenfluh DA, Sukthankar A, Gerber C. Is there an association between the individual anatomy of the scapula and the development of rotator cuff tears or osteoarthritis of the glenohumeral joint? A radiological study of the critical shoulder angle. Bone Joint J. 2013;95-B(7):935–41. doi: 10.1302/0301-620X.95B7.31028
  37. Kim JH, Gwak HC, Kim CW, et al. Difference of Critical Shoulder Angle (CSA) According to Minimal Rotation: Can Minimal Rotation of the Scapula Be Allowed in the Evaluation of CSA? Clin Orthop Surg. 2019;11(3):309–315. doi: 10.4055/cios.2019.11.3.309
  38. Chalmers PN, Beck L, Miller M, et al. Acromial morphology is not associated with rotator cuff tearing or repair healing. J Shoulder Elbow Surg. 2020;29(11):2229–2239. doi: 10.1016/j.jse.2019.12.035
  39. Suter T, Gerber Popp A, Zhang Y, et al. The influence of radiographic viewing perspective and demographics on the critical shoulder angle. J Shoulder Elbow Surg. 2015;24(6):e149–58. doi: 10.1016/j.jse.2014.10.021
  40. Nyffeler RW, Werner CM, Sukthankar A, Schmid MR, Gerber C. Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am. 2006;88(4):800–5. doi: 10.2106/JBJS.D.03042
  41. Ono Y, Woodmass JM, Bois AJ, et al. Arthroscopic Repair of Articular Surface Partial-Thickness Rotator Cuff Tears: Transtendon Technique versus Repair after Completion of the Tear-A Meta-Analysis. Adv Orthop. 2016;2016:7468054. doi: 10.1155/2016/7468054
  42. Jordan RW, Bentick K, Saithna A. Transtendinous repair of partial articular sided supraspinatus tears is associated with higher rates of stiffness and significantly inferior early functional scores than tear completion and repair: A systematic review. Orthop Traumatol Surg Res. 2018;104(6):829–837. doi: 10.1016/j.otsr.2018.06.007
  43. 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):722–8. doi: 10.1016/j.jse.2008.01.148
  44. Bollier M, Shea K. Systematic review: what surgical technique provides the best outcome for symptomatic partial articular-sided rotator cuff tears? Iowa Orthop J. 2012;32:164–72.
  45. Clavert P, Thomazeau H. Peri-articular suprascapular neuropathy. Orthop Traumatol Surg Res. 2014;100(8 Suppl):S409–11. doi: 10.1016/j.otsr.2014.10.002
  46. Moen TC, Babatunde OM, Hsu SH, Ahmad CS, Levine WN. Suprascapular neuropathy: what does the literature show? J Shoulder Elbow Surg. 2012;21(6):835–46. Erratum in: J Shoulder Elbow Surg. 2012;21(10):1442. doi: 10.1016/j.jse.2011.11.033
  47. Mononeuropathies. Clinical Guidelines. Available from: https://cr.minzdrav.gov.ru/view-cr/166_2?ysclid=macg8gr51l99917029 (In Russ.).
  48. Nolte PC, Woolson TE, Elrick BP, et al. Clinical Outcomes of Arthroscopic Suprascapular Nerve Decompression for Suprascapular Neuropathy. Arthroscopy. 2021;37(2):499–507. doi: 10.1016/j.arthro.2020.10.020
  49. Momaya AM, Kwapisz A, Choate WS, et al. Clinical outcomes of suprascapular nerve decompression: a systematic review. J Shoulder Elbow Surg. 2018;27(1):172–180. doi: 10.1016/j.jse.2017.09.025
  50. Belyak EA, Pashin DL, Lazko FL, et al. Experience of endoscopic decompression of the suprascapular nerve. Clinical practice. 2022;13(2):51–58. doi: 10.17816/clinpract108285. EDN: UUVDWT
  51. Cofield RH. Tears of rotator cuff. Instr Course Lect. 1981;30:258–73.
  52. Lafosse L, Piper K, Lanz U. Arthroscopic suprascapular nerve release: indications and technique. J Shoulder Elbow Surg. 2011;20(2 Suppl):S9–13. doi: 10.1016/j.jse.2010.12.003
  53. Costouros JG, Porramatikul M, Lie DT, Warner JJ. Reversal of suprascapular neuropathy following arthroscopic repair of massive supraspinatus and infraspinatus rotator cuff tears. Arthroscopy. 2007;23(11):1152–61. doi: 10.1016/j.arthro.2007.06.014
  54. Kong BY, Kim SH, Kim DH, et al. Suprascapular neuropathy in massive rotator cuff tears with severe fatty degeneration in the infraspinatus muscle. Bone Joint J. 2016;98-B(11):1505–1509. doi: 10.1302/0301-620X.98B11.37928
  55. Giniyatov AR, Egiazaryan KA, Tamazyan VO, et al. Release suprascapular nerve during arthroscopic suture of the suprascapular muscle. Department of Traumatology and Orthopedics. 2023;(4):7–15. doi: 10.17238/2226-2016-2023-4-7-15 EDN: JLMSFK
  56. Yang P, Wang C, Zhang D, et al. Comparison of clinical outcome of decompression of suprascapular nerve at spinoglenoid notch for patients with posterosuperior massive rotator cuff tears and suprascapular neuropathy. BMC Musculoskelet Disord. 2021;22(1):202. doi: 10.1186/s12891-021-04075-1
  57. Costouros JG, Porramatikul M, Lie DT, Warner JJ. Reversal of suprascapular neuropathy following arthroscopic repair of massive supraspinatus and infraspinatus rotator cuff tears. Arthroscopy. 2007;23(11):1152–61. doi: 10.1016/j.arthro.2007.06.014
  58. Sachinis NP, Papagiannopoulos S, Sarris I, Papadopoulos P. Outcomes of Arthroscopic Nerve Release in Patients Treated for Large or Massive Rotator Cuff Tears and Associated Suprascapular Neuropathy: A Prospective, Randomized, Double-Blinded Clinical Trial. Am J Sports Med. 2021;49(9):2301–2308. doi: 10.1177/03635465211021834

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2. Fig. 1. Diagrammatic MRI of the shoulder joint: a type A rotator cuff tear.

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3. Fig. 2. Diagrammatic MRI of the shoulder joint: a type B rotator cuff tear.

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4. Fig. 3. Diagrammatic MRI of the shoulder joint: a type C rotator cuff tear.

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5. Fig. 4. Flowchart of publication search and selection.

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6. Fig. 5. Diagrammatic CT image of the shoulder joint. CSA is measured as the angle formed between a line drawn from the superior point of the glenoid process of the scapula to the inferior point and a line drawn from the inferior point of the glenoid process of the scapula to the inferolateral border of the acromion.

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7. Fig. 6. Diagrammatic CT image of the shoulder joint. LAA is the angle formed between a line drawn along the superior and inferior points of the articular process of the scapula and a line drawn along the inferior surface of the acromion.

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8. Fig. 7. Diagrammatic CT image of the shoulder joint. AI is calculated as the ratio of the length from the joint plane to the lateral edge of the acromion and the length from the joint plane to the lateral edge of the humeral head (A/B).

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