Complete the tear or go for a PASTA repair?
When faced with a repairable PASTA lesion (typically small tendon retraction and 40-50% footprint exposure), surgeons have two options: either complete the tear followed by a standard rotator cuff repair, or maintain the remaining bursal fibers and perform a transtendinous repair.
Studies have shown drawbacks to completing the tear, including creating a length tension mismatch1, changing the normal biomechanics of the cuff, and creating a greater potential for non-anatomic recreation.2 Conversely, comparing these two approaches has shown a transtendinous approach provides less statistically significant gapping, higher mean ultimate failure strength, and biomechanic superiority.2
A transtendon approach is a reliable procedure that can be expected to produce a good outcome with significant pain relief and improved shoulder scores in 98% of patients.3,4 Studies have shown that smaller anchors cause less damage to tendon tissue and suggest smaller anchors should be considered for transtendon procedures.5 CONMED's Y-Knot® Flex All-Suture anchor provides distinct advantages for transtendinous PASTA repair techniques.
Y-Knot® PRO Flex All-Suture Anchor
This small yet strong anchor features cleatless technology
PopLok® Knotless Suture Anchor
Want the option to tension after your anchor is seated?
Super Revo® FT and ThRevo® FT Suture Anchor
An easy-to-use, self-punching, titanium option
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1 Lo and Burkhart, Transtendon arthroscopic repair of partial-thickness, articular surface tears of the rotator cuff, Arthroscopy, 2004.
2 Gonzalez-Lomas et al., J Shoulder Elbow Surg 2008; 17:722-728
3 Castagna et al., Predictive factors of subtle residual shoulder symptoms after transtendinous arthroscopic cuff repair, American Journal of Sports Medicine, 2009.
4 Snyder et al. Long-term outcome for arthroscopic repair of partial articular-sided supraspinatus tendon avulsion, Arthroscopy, 2013.
5 Qing-Song Zhang et al., Comparison of the tendon damage caused by four different anchor systems used in transtendon rotator cuff repair, Advances in Orthopaedics, 2012.