Navigating through daily life, our shoulders bear the brunt of much physical demand, facilitating nearly every movement from the mundane to the extraordinary. However, the complexity of this joint means it’s also vulnerable to injuries, especially within the supraspinatus tendon, crucial for a range of motions. Addressing these injuries requires not just a deep understanding of the shoulder’s mechanics but also a forward-thinking approach to treatment. Enter a new surgical technique, setting the stage for an evolution in how one of the most frequent shoulder injuries is treated. This innovation not only offers hope for more effective recovery but also challenges our conventional expectations of healing, marking a significant step forward in patient care.

Researchers Peiguan Huang and Dr. Xiaojun Tang from the University of South China have made a significant advancement in the field of surgery by introducing an innovative arthroscopic technique designed to treat partial articular-sided supraspinatus tendon avulsion (PASTA) lesions. Their work, detailed in the journal Arthroscopy Techniques, combines the strengths of traditional transtendon repair with the precision of minimalistic completion repair. This new approach aims to overcome the challenges and limitations of existing surgical methods, offering a promising solution for patients and practitioners alike.

PASTA lesions, which are partial-thickness tears of the rotator cuff affecting the supraspinatus tendon, pose a significant challenge in surgery. While these tears do not have the natural ability to heal and can progress to full-thickness tears if left untreated, the choice between arthroscopic transtendon and completion repair has been a subject of debate. Each method has its pros and cons in terms of pain relief, functional improvement, and the preservation of tendon integrity.

The new “mini-incision” transtendon technique proposed by Huang and Dr. Tang minimizes the trauma usually caused by anchor implantation during surgery and introduces additional intra-articular working access through a small incision on the supraspinatus tendon. This method not only maintains the structural integrity of the residual bursal layer fibers but also ensures an anatomical reattachment of the ruptured tendon to the articular-side footprint, presenting a leap forward in treating PASTA lesions.

Peiguan Huang remarked on the essence of their approach, emphasizing that “the ‘mini-incision’ transtendon pattern combines transtendon with mini-completion repair, is able to minimize the trauma from anchor insertion and add more intra-articular working access using a ‘mini-incision’ on the supraspinatus tendon.”

The research emphasizes the importance of the precise placement of suture anchors into the footprint of the greater tuberosity for successful surgical outcomes. “Anatomically restored articular-side tendon is performed in the glenohumeral joint,” Huang explains, highlighting the meticulous approach required for this surgical technique to ensure optimal recovery and function post-surgery.

Furthermore, Huang shares insight into the benefits and considerations of their innovative technique. “The supraspinatus tendon receives minimal trauma, and the ‘mini-incision’ can be adopted as the second intra-articular working access,” he states, highlighting the method’s precision and minimal invasiveness. This approach is designed to facilitate a more accurate repair process, potentially leading to quicker patient recovery and less post-operative discomfort. However, Huang and Dr. Tang are candid about the technique’s limitations, acknowledging a potential for a 5-mm trauma to the supraspinatus tendon. Despite this, the strategic approach to incision and repair they’ve developed represents a significant advancement in treating PASTA lesions, balancing meticulous surgical intervention with patient recovery needs. This pioneering study by Peiguan Huang and Dr. Xiaojun Tang opens new avenues for advancing surgical techniques, especially in the realm of complex shoulder injuries. With an increasing demand for less invasive yet more effective treatment options, their “mini-incision” transtendon repair technique promises to set a new standard for addressing PASTA lesions. This approach offers the potential for faster, less painful recovery processes, heralding a significant leap forward in patient care and surgical outcomes.


Peiguan Huang, Xiaojun Tang, “Arthroscopic ‘Mini-Incision’ Transtendon Repair of Shoulder Partial Articular-Sided Supraspinatus Tendon Avulsion,” Arthroscopy Techniques, 2023.