Partial Cuff Repair in Rotator Cuff Tears: Current Concepts and Clinical Considerations.

Abstract

Background: Partial-thickness rotator cuff tears are a commonly underreported shoulder condition that can lead to pain, functional impairment, and limited range of motion. These tears affect both young, active individuals and the elderly. If left untreated, partial-thickness tears may progress to full-thickness tears over time.

Classification and diagnosis: Partial-thickness tears can occur on the bursal side, articular side, or within the tendon itself (intratendinous). The severity of pain and the risk of tear progression depend on the tear's location. Diagnosis often involves physical examination, clinical suspicion, and imaging techniques such as ultrasound, MRI, or diagnostic arthroscopy. Despite these methods, some tears may remain undetected.

Treatment options: Conservative management, typically spanning 3 to 6 months, is often recommended for non-athletic patients. Treatment may include Platelet-Rich Plasma (PRP) therapy, corticosteroid injections, prolotherapy, sodium hyaluronate, anaesthetics, atelocollagen, and physiotherapy. If pain and function do not improve adequately, arthroscopic repair is indicated. Repairs may be performed in situ or converted to full-thickness repairs. Operative treatment followed by a structured 6-month rehabilitation protocol generally leads to good to excellent functional outcomes.

Conclusion: Early and accurate diagnosis, along with a tailored treatment plan, is essential to prevent the progression of partial-thickness rotator cuff tears to irreparable damage or cuff arthropathy, thereby ensuring optimal patient outcomes.