Should the term PASTA for rotator cuff injuries be reassessed? / ¿Debemos re-evaluar el término PASTA en lesiones del Manguito Rotador?

ABSTRACT

Partial tears of the rotator cuff were initially described by Codman in 1934.1 However, it was not until 2001 that Snyder coined the term PASTA to describe an avulsion-type injury on the articular side of the supraspinatus tendon, causing pain and functional disability, for which some patients had to undergo surgery for symptom relief and for avoidance of disease progression.2 The advent of magnetic resonance imaging allowed confirming that articular side tears are much more frequent than bursal side ones, questioning the strictly mechanical concept by Neer, who said that the rotator cuff damage was because the subacromial impingement.3 Many surgical strategies for PASTA lesions have been designed, all of which consist of re-attachment the tendon in the greater tuberosity either transtendon or completing it through the bursal side. Snyder started from the premise that what he observed in the arthroscopic view of the glenohumeral joint, was the supraspinatus tendon; consequently, any lesion in the crescent area, distal to the rotator cable seen through the articular side was considered as a tendinous lesion.