In situ transtendon repair outperforms tear completion and repair for partial articular-sided supraspinatus tendon tears

This biomechanical study compared 2 repair techniques for high-grade, partial, articular-sided supraspinatus tendon tears of the rotator cuff: transtendon in situ repair and tear completion with repair. Standardized, 50% partial, articular-sided supraspinatus lesions were created in 10 pairs of matched fresh, frozen cadaveric shoulders: 10 underwent partial lesion repair with an in situ transtendon technique using 2 suture anchors. In the contralateral 10 shoulders, the partial lesion was converted to a full-thickness tear and repaired with a double-row technique, using 4 suture anchors. Cyclic loading to failure of the supraspinatus tendon was performed using a material testing machine. Gap formation was measured for each rotational position and each incremental load. The in situ transtendon repair had statistically significant less gapping (P = .0001) and higher mean ultimate failure strength (P = .0011) than the double-row repair. In situ transtendon repair was biomechanically superior to tear completion for partial, articular-sided supraspinatus tears.