Original ArticleA new arthroscopic classification of articular-sided supraspinatus footprint lesions: A prospective comparison with Snyder's and Ellman's classification
Section snippets
Material and methods
From October 2002 to May 2004, 56 consecutive patients (26 men and 30 women) with a mean age of 54 years (range, 27-71 years) who had an articular-sided anterosuperior rotator cuff tear, diagnosed clinically and by magnetic resonance imaging, underwent standardized diagnostic arthroscopy and were prospectively documented by use of an intraoperative documentation sheet.
Of the patients, 26 (46.4%) reported a traumatic history, and the mean duration of symptoms was 24.6 months (range, 1 week to 25
Results
In 56 patients, an articular-sided partial-thickness rotator cuff tear was confirmed arthroscopically. Of these 56, 16 (28.6%) had a combined articular-sided supraspinatus and subscapularis tendon tear.
A positive cable sign was found in 62.5% (35 patients).
When the partial-thickness supraspinatus tendon tears were classified according to Ellman,4 26 patients (46.4%) had an A 1 tear, 13 (23.2%) had an A 2 tear, and 17 (30.4%) had an A 3 tear.
When the articular-sided supraspinatus tendon tears
Discussion
We describe a 2-dimensional classification of articular-sided supraspinatus tendon tears in the coronal plane as well as the sagittal plane, with regard to the origin of articular-sided partial tears at the tendon insertion. Within the entire patient group, we did not observe any articular-sided partial tear starting in the middle of the tendon without regard to the tendon insertion. Nearly 60% of our patients had a nontraumatic history.
Degenerative rotator cuff tears develop predominantly at
References (25)
Subscapularis, medial, and lateral head coracohumeral ligament insertion anatomy. Arthroscopic appearance and incidence of “hidden” rotator interval lesions
Arthroscopy
(2001)- et al.
Internal impingement in the etiology of rotator cuff tendinosis revisited
Arthroscopy
(2003) Arthroscopic treatment of rotator cuff disease
J Shoulder Elbow Surg
(1995)- et al.
Impingement of the deep surface of the subscapularis tendon and the reflection pulley on the anterosuperior glenoid rim: a preliminary report
J Shoulder Elbow Surg
(2000) - et al.
Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study
J Shoulder Elbow Surg
(2004) - et al.
Histologic and biomechanical characteristics of the supraspinatus tendon: reference to rotator cuff tearing
J Shoulder Elbow Surg
(1994) - et al.
Supraspinatus tears: propagation and strain alteration
J Shoulder Elbow Surg
(2003) - et al.
The supraspinatus footprint: an anatomic study of the supraspinatus insertion
Arthroscopy
(2004) - et al.
Stress distribution in the supraspinatus tendon with partial-thickness tears: an analysis using two-dimensional finite element model
J Shoulder Elbow Surg
(2006) - et al.
Subluxations and dislocations of the tendon of the long head of the biceps
J Shoulder Elbow Surg
(1998)