Revisiting the rotator cuff footprint

Abstract

Newer studies challenged the traditionally held belief that the supraspinatus inserts on the entire superior facet and the infraspinatus is attached on the entire middle facet of the greater tuberosity. They showed that the infraspinatus tendon is thicker anteriorly and can be differentiated from the posterior part of the supraspinatus. Hence, the newer studies showed that the supraspinatus attached in a much smaller area than previously thought, and infraspinatus occupied the lateral part of the superior facet of the greater tuberosity. This review aimed to present all the older and current knowledge of the rotator cuff insertion and discuss how this knowledge may affect the surgical repair of the rotator cuff tendons. Our review has synthesized and compared the differences and similarities between the older and the newer knowledge about the footprint anatomy of the cuff tendons and the capsule attachment. We have also highlighted how the newer knowledge impacts the way we treat the tears of the rotator cuff tendons. Level of evidenceReview of basic science studies.