“Mini-Incision” Transtendon Double-Pulley Suture-Bridge Repair of PASTA Lesion

Transtendon repair is increasingly applied in the treatment of PASTA (partial articular supraspinatus tendon avulsion) lesions, but a “tendon hole” from anchor insertion, which will break the intact bursal layer and potentially result in tear completion, is an unavoidable problem. The “mini-incision” transtendon double-pulley suture bridge presented in the study is a pragmatic technique in treatment of PASTA lesion. The 4 suture strands on the medial-row anchor provide enough biomechanical strength on the reattached articular layer, the “mini-incision” minimizes iatrogenic trauma on the bursal layer, and double-pulley suture-bridge smoothly covers the “mini-incision” so as to achieve anatomical reduction of articular and bursa side of supraspinatus tendon. The surgical technique is described, as well as pearls, pitfalls, advantages, and disadvantages.