ABSTRACT
Partial thickness rotator cuff tears are extremely common in both younger and older patients with shoulder pain. Patients with symptomatic partial thickness rotator cuff tears who fail nonoperative treatment, including physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), cortisone injections, and rest, are candidates for surgery. Many surgical options exist for managing partial thickness rotator cuff tear (PTRCT), including debridement of rotator cuff tear, subacromial decompression, arthroscopic in situ repair, or completion of the tear followed by open, mini-open, or all arthroscopic repair. Tears are classified according to the percent of thickness of tear, number of tendons involved, and whether it involves the bursal or articular side. Partial articular supraspinatous tendon avulsion (PASTA) lesions refer to partial articular supraspinatous tendon avulsions. While a consensus has not been established for treatment, the authors have created general guidelines. If 25% of cuff is torn, rotator cuff debridement and subacromial decompression is performed. If 50% of cuff is torn, an in situ all-arthroscopic repair to footprint is performed without completing the tear. If 75% of cuff is torn, the tear is completed and all-arthroscopic rotator cuff repair is performed. Bursal-sided tears have superior results when an acromioplasty is performed. For intratendinous laminar tears, intratendinous repair is performed. In younger throwing athletes, the authors favor intratendinous repairs and avoid acromioplasty.
