Comma sign-directed repair of anterosuperior rotator cuff tears

Matthew Dilisio, Lionel Neyton

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The comma sign was described as an arthroscopic landmark to identify the torn subscapularis stump to mobilize and repair the tendon in anterosuperior rotator cuff tears. It was hypothesized that it is composed of the humeral attachments of the superior glenohumeral and coracohumeral ligaments. This arthroscopic finding has since become accepted orthopaedic nomenclature pathognomonic for subscapularis tears and a key component of subscapularis tear classification. We propose an alternative theory of the pathoanatomy of the comma sign in anterosuperior rotator cuff tears and present the technique of comma sign-directed repairs of combined subscapularis and supraspinatus lesions. After appropriate releases, tendon-to-tendon repair of the distal-superior aspect of the comma sign to the upper border of the remnant subscapularis results in anatomic re-creation of the intra-articular portion of the torn subscapularis with concomitant reduction of the anterior leading edge of the supraspinatus and reconstitution of the rotator cable complex. A tension-free, single-anchor subscapularis repair is then performed to secure the tendon to the lesser tuberosity. After subscapularis repair, the supraspinatus that was previously retracted to the glenoid rim takes the appearance of a crescent-type tear that is easily approximated to its anatomic insertion.

Original languageEnglish
Pages (from-to)e695-e698
JournalArthroscopy Techniques
Volume3
Issue number6
DOIs
StatePublished - Dec 1 2014

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Rotator Cuff
Tendons
Rotator Cuff Injuries
Tenotomy
Tears
Ligaments
Terminology
Orthopedics
Joints

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

Comma sign-directed repair of anterosuperior rotator cuff tears. / Dilisio, Matthew; Neyton, Lionel.

In: Arthroscopy Techniques, Vol. 3, No. 6, 01.12.2014, p. e695-e698.

Research output: Contribution to journalArticle

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