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. 2026 Feb 19.
doi: 10.1186/s13018-025-06643-w. Online ahead of print.

Comparison of articular-sided, bursal-sided, and intratendinous partial rotator cuff tears: outcomes of surgical repair from a multicenter cohort study

Laurent Audigé #  1   2   3 , Cornelia Baum #  4 , Thomas Stojanov  5   6 , Claudio Rosso  7 , Philipp Moroder  8   9 , Thomas Suter  10 , Mai Lan Dao Trong  11 , Emanuel Benninger  12 , Beat Moor  13 , Christophe Spormann  14 , Holger Durchholz  15 , Gregory Cunningham  16   17 , Alexandre Lädermann  17   18 , Michael Schär  19 , Matthias Flury  20 , Karim Eid  21 , Markus Scheibel  8   9 , Christian Candrian  22 , Bernhard Jost  23 , Matthias A Zumstein  24   25 , Karl Wieser  26 ; ARCR_Pred Study Group; Andreas M Müller  5   27
Collaborators, Affiliations

Comparison of articular-sided, bursal-sided, and intratendinous partial rotator cuff tears: outcomes of surgical repair from a multicenter cohort study

Laurent Audigé et al. J Orthop Surg Res. .

Abstract

Background: Outcomes of surgical treatment of partial-thickness rotator cuff tears (PTRCTs) are underreported. This study investigates (1) arthroscopic repair techniques for partial supraspinatus (SSP) tears and (2) outcomes based on tear location (articular-side vs. bursal-side vs. intratendinous) in a large multicenter cohort.

Methods: As part of a cohort study across 19 centers (ARCR_Pred study), adult patients with primary arthroscopic repair of a PTRCT involving the SSP tendon were prospectively enrolled over an 18-month period beginning in June 2020, operated, and followed-up for 24 months. Tear location (articular-side, bursal-side, intratendinous) and surgical technique (tear completion, suture configuration) were documented. Functional (pain, strength, Range of Motion [ROM], Constant -Murley Score [CMS]) and patient-reported (Subjective Shoulder Value [SSV], quality of life [Eq. 5D utility]) outcomes were assessed at baseline, 6, 12, and 24 months. Adverse events were recorded through 24 months. Baseline factors affecting repair techniques were explored. Outcomes and adverse events were compared across tear locations.

Results: The ARCR_Pred cohort of 973 patients included 147 partial tears (15.7%), with 128 (87%) involving the SSP tendon: 69 (54%) articular-sided, 35 (27%) bursal-sided, and 24 (19%) intratendinous. SSP PTRCTs were repaired in 121 patients using single-row (45%) or double-row (55%) techniques. Completion of partial tears was performed in 46% of articular-sided and 35% of bursal-sided tears, and was positively associated with tendon thickness (p = 0.001). Completed tears were 1.4 times more likely to be repaired using double-row sutures (p = 0.037). ROM for flexion was greater in articular-sided tears (p = 0.010) compared to bursal-sided tears. Other outcome parameters showed overall no significant differences between groups (p ≥ 0.141) with a tendency for faster recovery in the bursal-sided tears. Adverse events were mostly mild, with pain (15.7%) and stiffness (13.2%) being common. Severe adverse events (Grade III) were rare, occurring in 3% (4/121) of cases.

Conclusions: Arthroscopic rotator cuff repair is safe and effective for PTRCTs showing postoperative improvement in shoulder function and patient quality of life. Flexion ROM recovered better in articular-sided tears than bursal-sided tears. Surgical techniques varied, influenced by tendon thickness and tear completion.

Trial registration: ClinicalTrial.gov registration number NCT04321005.

Keywords: Arthroscopy; Cohort studies; Epidemiology; Orthopedics; Partial tears; Rotator cuff tears; Shoulder; Surgical repair.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

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