Partial Rotator Cuff Tear: Shoulder Ligament Plication Suture

For partial rotator cuff tears on the articular side (the surface facing the joint), plication suture is one of the most effective non-surgical treatments available. It is, in effect, a non-surgical equivalent of arthroscopic repair — but performed through a needle under ultrasound guidance, without incision.

Articular-side tears: why they are different

The rotator cuff has two surfaces: the articular surface (facing the glenohumeral joint) and the bursal surface (facing the subacromial bursa). Articular-side tears are the more common type and present a specific challenge: they often extend and enlarge with continued mechanical loading, even at everyday activity levels.

How plication suture works for articular-side tears

The plication suture procedure physically approximates the torn tendon edge to the bone footprint using a knotless bioabsorbable anchor suture (Dr. Lee's Patent No. 10-2814890). This achieves three critical goals: (1) prevents further tearing by eliminating the mechanical stress concentration at the tear edge; (2) restores normal tendon tension and biomechanics; (3) creates a favorable biological environment for healing by bringing the tendon into contact with the vascularized bone surface.

Why conventional plication suture (tendon-to-tendon) is inferior

Traditional plication suture techniques only tighten the tendon against itself — not anchoring it to bone. This reduces the holding force significantly and provides inadequate resistance to re-tearing. Dr. Lee's bone-anchoring technique provides substantially greater structural fixation, which is why outcomes are superior to conventional approaches.

Fixing a torn tendon to bone rather than to itself is the difference between a repair that holds and one that fails under load.