{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:58:19Z","timestamp":1790056699873,"version":"4.0.1"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To establish evidence\u2010based consensus recommendations regarding the diagnosis and treatment of partial\u2010thickness posterosuperior rotator cuff tears (PT\u2010PS\u2010RCTs). This part addresses the definition, classification, natural history and diagnosis of these controversial conditions in shoulder surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This official European Society of Sports Medicine, Knee Surgery and Arthroscopy\u2013European Shoulder Associates (ESSKA\u2010ESA) Formal Consensus was conducted according to the ESSKA Formal Consensus Methodology. A Steering Group developed 33 questions, followed by a standardized literature search and evidence review. For each question, a consensus statement was drafted and assigned recommendation grades (A\u2013D) according to the level of evidence. An independent Rating Group evaluated all statements until strong agreement was achieved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve recommendations were generated with three Grade A, three Grade B, two Grade C, five Grade D and strong agreement. Grade A was found for the use of multiple classification systems in unison to characterize these injuries and for the distinction between acute and chronic tears. Scientific presumption level (Grade B) was found for the increased incidence of articular injuries in overhead and contact athletes and for the absence of a link between calcifying tendinitis and PT\u2010PS\u2010RCTs. Grade C was found to define the risk and timeframe of tear progression and the ideal imaging modality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This ESSKA\u2010ESA Formal Consensus recommends that PT\u2010PS\u2010RCTs should be classified according to tear location, depth and tendon involvement. The aetiology of these injuries is multifactorial, and their progression is unpredictable. Current imaging modalities have limitations in characterizing these lesions. The present consensus provides clinicians with a practical evidence\u2010based framework for the diagnosis and classification of PT\u2010PS\u2010RCTs while identifying key priorities for future clinical research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, formal consensus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70587","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:57:35Z","timestamp":1788796655000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The 2026 ESSKA\u2010ESA formal consensus on partial\u2010thickness posterosuperior rotator cuff tears (Part 1): Definitions, classifications, etiologies, natural history and diagnosis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9824-0218","authenticated-orcid":false,"given":"Jean","family":"Kany","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Clinique de l'Union, Ramsay, Boulevard de Ratalens Saint Jean France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5985-3388","authenticated-orcid":false,"given":"Miguel Angel Ruiz","family":"Iban","sequence":"additional","affiliation":[{"name":"Departamento de Cirug\u00eda, Facultad de Medicina Ciencias Sanitarias y Medicosociales, Alcal\u00e1 de Henares Universidad de Alcal\u00e1 Madrid Spain"},{"name":"Unidad de Hombro y Codo Hospital Universitario Ram\u00f3n y Cajal Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2846-6999","authenticated-orcid":false,"given":"Claudio","family":"Rosso","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Unit ARTHRO Medics Ltd Basel Switzerland"},{"name":"Medical Faculty University of Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2516-4760","authenticated-orcid":false,"given":"Chris","family":"Peach","sequence":"additional","affiliation":[{"name":"Manchester Shoulder and Elbow Unit Manchester University NHS Foundation Trust, Wythenshawe Hospital Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"M\u00e9tais","sequence":"additional","affiliation":[{"name":"Elsan, Hopital priv\u00e9 La Chataigneraie Beaumont France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3407-7658","authenticated-orcid":false,"given":"Carlos Maia","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital da Luz Torres de Lisboa Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6054-6078","authenticated-orcid":false,"given":"Emilio","family":"Calvo","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Reconstructive Surgery Unit, Department of Orthopaedic Surgery and Traumatology Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7399-8762","authenticated-orcid":false,"given":"Maristella Francesca","family":"Saccomanno","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Fondazione Policlinico Universitario A. Gemelli, IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berte","family":"B\u00f8e","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9798-0938","authenticated-orcid":false,"given":"Emmanouil","family":"Brilakis","sequence":"additional","affiliation":[{"name":"Brilakis Orthopaedics, Athens Medical Group Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7402-756X","authenticated-orcid":false,"given":"Kerem","family":"Bilsel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology International Joint Center (IJC), Acibadem Maslak Hospital Acibadem Mehmet Ali Aydinlar University Istanbul Sariyer T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7558-2506","authenticated-orcid":false,"given":"Ladislav","family":"Kovacic","sequence":"additional","affiliation":[{"name":"Arbor mea Artro center Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7640-6945","authenticated-orcid":false,"given":"Antoon Van","family":"Raebroeckx","sequence":"additional","affiliation":[{"name":"Shoulder Training &amp; Research Center, Orthokliniek AZ Nikolaas Puurs\u2010Sint\u2010Amands Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuno","family":"Gomes","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital das For\u00e7as Armadas\u2014Polo do Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1027-8893","authenticated-orcid":false,"given":"Frank","family":"Martetschl\u00e4ger","sequence":"additional","affiliation":[{"name":"Deutsches Schulterzentrum, Deutsches Zentrum f\u00fcr Obere Extremit\u00e4t ATOS Clinic Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3551-6360","authenticated-orcid":false,"given":"Philippe","family":"Beaufils","sequence":"additional","affiliation":[{"name":"ESSKA Consensus Projects Advisor Versailles France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2078-2241","authenticated-orcid":false,"given":"Felix G. 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