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Partial articular side tendon avulsion

Seok Hahn, Young Han Lee, Yong-Min Chun, Eun Hae Park, Jin-Suck Suh
Background Specific findings on magnetic resonance arthrography (MRA) that indicate the need for surgery in patients with partial articular-sided supraspinatus tendon avulsion (PASTA) are not well understood. Purpose To determine which MRA findings are characteristic of patients who undergo surgery for PASTA. Material and Methods From July 2011 to February 2014, MRA findings for patients treated for PASTA were retrospectively reviewed. The patients were divided into two groups: conservative treatment and surgical repair...
September 2017: Acta Radiologica
Giovanni Battista Vinanti, Alberto Rossato, Daniele Scrimieri, Massimo Petrera
PURPOSE: To evaluate the outcomes of arthroscopic transtendon repair of partial articular-sided supraspinatus tendon avulsion (PASTA) in a large study group. METHODS: A retrospective review of prospectively collected data was conducted. One hundred and eighteen patients with PASTA lesion (grade A2-A3) who underwent arthroscopic transtendon repair were identified, of which 110 were eligible for the study. Ten patients were lost at final follow-up leaving a study group of 100 patients (52 male, 48 female)...
July 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Sang-Eun Park, Jae-Jung Jeong, Karnav Panchal, Jong-Yun Lee, Hyung-Ki Min, Jong-Hun Ji
PURPOSE: The purpose of the present study was to describe the use of a novel hybrid surgical technique-arthroscopic-assisted plate fixation-and evaluate its clinical and anatomical outcomes in the management of large, displaced greater tuberosity (GT) fractures with comminution. METHODS: From 2009 to 2011, this novel technique was performed in 11 patients [2 men and 9 women; median age, 64 years (range 41-83 years)] with large, comminuted GT fractures, with fragment displacements of >5 mm...
December 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Timothy Hartshorn, Jian Ren, C Thomas Vangsness
This study evaluated the utility of optical coherence tomography (OCT) in imaging porcine and human rotator cuff (RTC) tissue, analyzed its effectiveness in identifying clinical pathology, and correlated these findings with histologic examination. Twelve human cadaveric and 6 porcine shoulders were evaluated. Six-millimeter-wide bone sections were harvested from the proximal humerus of each specimen, with each containing the entire enthesis of the respective RTC tendon, as well as 2 cm of tendon medial to the enthesis...
September 2015: Orthopedics
Yi Wang, Liangyu Lu, Zhe Lu, Lei Xiao, Yifan Kang, Zimin Wang
OBJECTIVE: To evaluate clinical efficacy of arthroscopic transtendinous repair of partial articular-sided PASTA (partial articular supraspinatus tendon avulsion) injury. METHODS: From February 2011 to July 2014, 12 cases of PASTA, aged 29 to 72 years with an average of 52.9 ± 13.3 years, were treated arthoscopically. To repair PASTA, articular-sided rotator cuff tear was explored, injury site was punctured and labeled with PDS absorbable monofilament suture (Ethicon, Somerville, NJ, USA) suture, subacromial bursa was cleaned up with acromioplasty, and integrity of bursa-side rotator cuff was assessed...
2015: International Journal of Clinical and Experimental Medicine
Lindsey S Caldwell, Anna R Cooper, John C Elfar
There is no current consensus in the literature on the optimal technique for surgical treatment of partial articular-sided supraspinatus tendon avulsion (PASTA) lesions, although most techniques described to date require takedown of the partially torn tendon or passage of an anchor through the already damaged tendon. We describe a novel inside-out repair technique for partial articular surface supraspinatus tears that does not require further disruption of the partially torn tendon by passage of an anchor.
October 2014: Arthroscopy Techniques
Jian Xiao, Guoqing Cui
BACKGROUND: There have been few studies using magnetic resonance imaging (MRI) to evaluate the clinical outcomes and structural results after arthroscopic repair of bursal-side partial-thickness rotator cuff tears (PTRCTs). METHODS: From 2009 to 2012, 73 consecutive patients with bursal-side PTRCTs underwent arthroscopic repair. Fifty-nine of them were retrospectively evaluated as Ellman classification grade 2 (group A, n = 11) or grade 3 (group B, n = 48). All repairs were performed with a technique that preserved the intact articular fibers and repaired the avulsed bursal flap...
February 2015: Journal of Shoulder and Elbow Surgery
Prithviraj Chavan, Todd K Gothelf, Keith M Nord, William H Garrett, Keith D Nord
Typically, rotator cuff repair is performed two-dimensionally while visualizing the subacromial space. To achieve a more complete repair, sutures can be retrieved from inside the joint utilizing a penetrating suture device through the anterolateral portal, which permits visualization of the articular side and bursal side of the rotator cuff tear. Utilizing other portals can leave the sutures out of sight and reach. The anterolateral portal helps capture both leaves of a delaminated tear and places the sutures in the center of the field for retrieval and tying...
2014: Journal of Surgical Orthopaedic Advances
Eric W Edmonds, Douglas D Dengerink
The overhead athlete is at unique risk for injury because of the mechanics associated with rapid shoulder elevation, abduction, and external rotation. Angulation of the humeral head against the posterosuperior glenoid can cause rotator cuff tendon and labral impingement. The throwing or striking motion of baseball, softball, water polo, tennis, racquetball, and volleyball may result in scapular dyskinesis, partial articular-sided supraspinatus avulsions, and posterosuperior labral tears. The SICK scapula syndrome (scapular malposition, inferior medial border prominence, coracoid pain and malposition, and dyskinesis of scapular movement) is thought to increase the risk of injury in the overhead athlete...
April 1, 2014: American Family Physician
L P Stoppino, P Ciuffreda, M Rossi, M Lelario, C Bristogiannis, R Vinci, E A Genovese, L Macarini
BACKGROUND: To evaluate the diagnostic performance of magnetic resonance arthrography (MR-A) of the shoulder in the diagnosis of rotator cuff tears involving the humeral insertion of the supraspinatus and infraspinatus tendon (footprint), using arthroscopy as the reference standard. MATERIALS AND METHODS: The study population included 90 consecutive patients with history and clinical diagnosis of instability of the shoulder, rotator cuff tear or posterosuperior glenoid impingement...
August 2013: Musculoskeletal Surgery
Luigi Murena, Gianluca Canton, Daniele A Falvo, Eugenio A Genovese, Michele F Surace, Paolo Cherubino
We report the use of the double-pulley technique for arthroscopic fixation of the bony PASTA (partial articular surface tendon avulsion) lesion. Arthroscopic examination documented a 15-mm-long and 8-mm-wide comminuted bony avulsion with 2 main fragments. Two double-loaded suture anchors were placed with a transtendinous technique at the anterior and posterior edges of the lesion respecting the tendon insertion to the avulsed fragment. The medial sutures were retrieved through the intact supraspinatus tendon medially to the fracture...
February 2013: Arthroscopy Techniques
Kyle D Stuart, Ronald P Karzel, Mehrdad Ganjianpour, Stephen J Snyder
PURPOSE: To assess the long-term clinical outcome of arthroscopic transtendon repair of partial articular-sided supraspinatus tendon avulsion (PASTA) lesions using University of California, Los Angeles (UCLA) and Short Form 36 (SF-36) scores. METHODS: We prospectively collected and retrospectively reviewed data on 15 patients who underwent arthroscopic transtendon PASTA repair between 1997 to 2001. The mean patient age was 50.4 years (range, 31 to 68 years). Mean follow-up was 13...
May 2013: Arthroscopy: the Journal of Arthroscopic & related Surgery
Eric A Eisner, Joanna H Roocroft, Molly A Moor, Eric W Edmonds
INTRODUCTION: In the adult population, rotator cuff tears are common and established treatment methods yield satisfactory results. In adolescents, however, these injuries are uncommon and few treatment methods and outcome reports exist. The purpose of this study was to examine a series of adolescent rotator cuff tears, identify associated pathology, and report treatment outcomes. METHODS: A retrospective comparative analysis of adolescent patients treated for rotator cuff tears diagnosed by magnetic resonance imaging (MRI) or arthroscopy between 2008 and 2010 was performed...
January 2013: Journal of Pediatric Orthopedics
K -H Frosch, N Proksch, A Preiss, A Giannakos
OBJECTIVE: Reduction and fixation of bony avulsions of the posterior cruciate ligament (PCL) through a minimally invasive dorsal approach to restore stability of the knee joint. Prevention of soft tissue damage through a minimally invasive procedure and achieving early functional rehabilitation by stable osteosynthesis. INDICATIONS: Bony tibial avulsions of the PCL and simple posteromedial tibial fractures. CONTRAINDICATIONS: Infections in or around the knee, critical soft tissue conditions and lack of patient compliance...
September 2012: Operative Orthopädie und Traumatologie
Kotaro Yamakado
PURPOSE: The purpose of this study was to examine the histopathologic features of the residual intact tissue of a partial articular surface tendon avulsion (PASTA) tear. METHODS: In 30 consecutive patients with PASTA lesions, biopsy specimens of the residual tendon were taken. The mean age was 60.4 years (range, 28 to 78 years). All tears were converted to full-thickness tears and arthroscopically repaired. None of the patients were overhead athletes. Samples were histopathologically examined and graded by use of a modified semiquantitative scale (between 0, normal appearance, and 21, most abnormal appearance)...
April 2012: Arthroscopy: the Journal of Arthroscopic & related Surgery
Amandeep Bhalla, Kevin Higashigawa, David McAllister
Since falling off a motorcycle 2 years earlier, an 8-year-old, right-hand-dominant boy reported anterior shoulder pain and weakness. After being evaluated by his family physician and completing a course of physical therapy with no symptomatic improvement, he was seen at our institution. Physical examination was remarkable for diminished strength with internal rotation (4/5). In addition, bellypress and lift-off tests were positive, suggesting a lesion of the subscapularis. Magnetic resonance imaging of the shoulder showed a full-thickness subscapularis tendon tear and a supraspinatus tendon signal that could have represented a partial-thickness tear vs supraspinatus tendinosis...
September 2011: American Journal of Orthopedics
Christoph Schaeffeler, Dirk Mueller, Chlodwig Kirchhoff, Petra Wolf, Ernst J Rummeny, Klaus Woertler
OBJECTIVES: To evaluate the prevalence, imaging characteristics and anatomical distribution of tears at the rotator cuff (RC) footprint with MR arthrography (MR-A) of the shoulder. METHODS: MR arthrograms obtained in 305 patients were retrospectively reviewed. Partial articular-sided supraspinatus tendon avulsions (PASTA), concealed interstitial delaminations (CID), reverse PASTA lesions and full-thickness tears (FT) at the humeral tendon insertion were depicted...
July 2011: European Radiology
David P Huberty, John D Schoolfield, Paul C Brady, Antonio P Vadala, Paolo Arrigoni, Stephen S Burkhart
PURPOSE: The purpose of this study was to determine the incidence of clinically significant postoperative stiffness following arthroscopic rotator cuff repair. This study also sought to determine the clinical and surgical factors that were associated with higher rates of postoperative stiffness. Finally, we analyzed the result of arthroscopic lysis of adhesions and capsular release for treatment of patients who developed refractory postoperative stiffness 4 to 19 months (median, 8 months) following arthroscopic rotator cuff repair...
August 2009: Arthroscopy: the Journal of Arthroscopic & related Surgery
Alessandro Castagna, Giacomo Delle Rose, Marco Conti, Stephen J Snyder, Mario Borroni, Raffaele Garofalo
BACKGROUND: Transtendinous repair is a well-known technique for the arthroscopic management of partial rotator cuff tear. However, there are not a lot of clinical follow-up studies in the literature reporting data on this approach, and, moreover, potential factors responsible to influence the outcomes have not been investigated. PURPOSE: To evaluate clinical outcomes after arthroscopic transtendinous repair and to identify predictive factors of residual shoulder symptoms...
January 2009: American Journal of Sports Medicine
Mark Tauber, Heiko Koller, Herbert Resch
Partial articular-surface tendon avulsion (PASTA) lesions of the supraspinatus muscle represent a common cause for shoulder impairment and a preceding pathology for full-thickness tendon tears. Arthroscopic tendon repair is a possible surgical method of treatment. The purposes of cuff repair are anatomical tendon healing, prevention of tear size progression to completion and reduction of shoulder pain. In this report, we describe a transtendon arthroscopic technique of transosseous refixation of articular-side partial tears leaving the bursal layer of the supraspinatus tendon intact...
June 2008: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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