PASTA Repair as a Rotator Cuff Surgery
A partial rotator cuff tear is more common in active individuals than full thickness tears. The tendons of the rotator cuff are quite strong, so it is common to see incomplete or partial tears with overuse or the natural aging process. With a traumatic event, the tendon may be more at risk to completely tear away from the bone at the attachment site. Many partial tears respond to non-operative measures but certain patients living in Van Nuys, Thousand Oaks or surrounding Los Angeles communities will require a surgical procedure to repair the partially torn tendon. Orthopedic shoulder surgeon, Dr. Mark Getelman is one of the world’s leading experts at a PASTA repair rotator cuff surgery. A PASTA repair was coined by the Southern California Orthopedic Institute (SCOI) and is designed to treat a partial articular supraspinatus tendon avulsion (PASTA).
PASTA Lesion – A Form of a Partial Rotator Cuff Tear
The rotator cuff is an important structure within the shoulder joint. The structure is composed of four muscle-tendon units that are responsible for helping provide joint stability and allowing overhead arm movements and rotation. Over time, a tendon can begin to change its internal structure, generally caused by overuse or the aging process. The tendon-muscle unit may begin to lift from its normal attachment site at the bone and cause a partial tear.
A partial rotator cuff tear is often classified as a partial “thickness” tear. Partial tears are a challenging injury to treat in certain cases. This is because the tear may be undersurface or articular, or may also occur on the top of the bursal surface of the tendon. In many cases, the bursal tears are more straight forward but the articular tears are often more difficult to manage and may require Dr. Getelman to perform a PASTA repair rotator cuff surgical procedure.
PASTA stands for a partial articular supraspinatus tendon avulsion.
- Partial: A partial tear of the tendon
- Articular: The articular surface is the under-side of the tendon
- Supraspinatus Tendon: A specific superior tendon of the rotator cuff
- Avulsion: An avulsion injury- typically a traumatic or overuse injury which causes some sort of pulling force and tears only part of the tendon
During a PASTA repair rotator cuff surgery, Dr. Getelman will insert a tiny camera into the shoulder joint using a minimally invasive arthroscopic approach to examine the frayed tendon on the articular side. He will then debride the frayed edges using a shaving device. The debridement provides clean edges for the repair.
The extent of the partial rotator cuff tear is then assessed, and a determination if a PASTA repair is indicated or if the tear would be better managed by completing the tear and repairing the entire thickness of the tendon. Controversy remains as to which option is best. Dr. Getelman will outline the differences in the techniques and the recovery process with each patient on an individual basis.