• ABSTRACT
    • Management of partial-thickness rotator cuff tears (PTRCTs) remains controversial, particularly regarding optimal timing of intervention, surgical technique, and prognostic indicators. There are three PTRCT subtypes: articular; bursal; and intrasubstance. The accurate assessment of percentage thickness of PTRCTs can be challenging; symptomatic PTRCTs that appear relatively innocuous on MRI can often appear much larger and involve a significantly greater depth of the tendon attachment when viewed arthroscopically, particularly following gentle debridement of pathological tendon. For articular-side lesions, remaining tendon quality and thickness can be gauged by probing with a needle from the bursal surface and tagged using a monofilament suture to locate the tear from an intact bursal surface, and full thickness arthroscopic double-row repair is recommended. Intrasubstance tears are more difficult to assess, and the sliding sensation and saline injection "bubble sign" tests may confirm and locate these tear types. Intrasubstance tears may be converted to bursal-side tears and treated as such.