PASTA Repair

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

y knot pro flex with black handle and white sutures

PopLok® Knotless Suture Anchor

Want the option to tension after your anchor is seated?

poplok knotless suture anchor tip with blue and white sutures coming out alongside smaller poplok tip

Super Revo® FT and ThRevo® FT Suture Anchor

An easy-to-use, self-punching, titanium option

super revo ft and threvo ft suture anchors laying parallel to each other

Don't Pass on Our Passers

The Spectrum® family of suture passing instruments sets the bar for precise, efficient, and versatile suture passing.

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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.