Abstract
We present an arthroscopic technique for partial-thickness rotator cuff tears involving simultaneous arthroscopy and bursoscopy (DA technique). The surgical technique is described, and its benefits are discussed.
Eleven patients with partial-thickness rotator cuff tears were treated with the DA technique. There were 6 articular side tears and 5 bursal side tears. Mean age at the time of surgery was 67.5 years. For articular-side partial tears, the DA technique was introduced after routine diagnostic arthroscopy and acromioplasty. With visualization of both the intra-articular and subacromial sides, a suture anchor was passed through the remaining intact tendon, and inserted into the bone at the articular margin. Two spinal needles were passed through the full-thickness layer medial to the articular side tear in the same manner. Anchor sutures were relayed with PDS, which was introduced into the articular side through the spinal needles, and bought back into the subacromial space. Sutures were finally tied in the subacromial space. For bursal side tears, a suture anchors was inserted with subacrmoial bursoscopy. The DA technique was then applied, and sutures were placed at the appropriate location and tied securely with double vision.
The mean operation time was 144.9 min and there were no intraoperative complications. The mean JOA score for the seven patients after a minimum 6-month follow-up was improved from 68.3 to 90.3 points.
Transtendon repair for partial articular side tears is technically demanding, but this DA technique is safe and secure, with no blind processes.
