{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T05:34:24Z","timestamp":1775453664512,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,11,1]],"date-time":"2013-11-01T00:00:00Z","timestamp":1383264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2013,11,1]],"date-time":"2013-11-01T00:00:00Z","timestamp":1383264000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purposes of this study were (1) to examine whether posterior delamination is hidden to the most commonly used posterior viewing portal compared with differential rotator cuff portals and (2) to observe posterior delamination patterns so that a treatment\u2010based classification system may be proposed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One\u2010hundred thirty consecutive patients undergoing arthroscopic rotator cuff repair by 4 different surgeons were evaluated for the presence of posterior delamination viewable through the posterior, posterolateral, and lateral portals. Randomized arthroscopic pictures were viewed by 2 independent blinded observers, and the Fleiss \u03ba was used to assess inter\u2010reliability agreement. In addition, patterns of posterior delamination and surgical treatment were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of posterior delamination was 88%. Only 11% of cases were visualized through the posterior portal, whereas 70% and 100% were visualized through the posterolateral and lateral portals, respectively. The Fleiss \u03ba was 0.78 (95% confidence interval, 0.73 to 0.83), indicating substantial agreement. Three general patterns of posterior delamination with specific surgical repair strategies were identified and subclassified into 5 types: type A1, full\u2010thickness tears with extensive posterior delamination separating the rotator cuff into 2 layers and sometimes with dissociation of the rotator cable; type A2, bursal\u2010sided partial\u2010thickness tears with posterior delamination; type B1, delamination with an L\u2010shaped bursal layer tear and crescent\u2010shaped articular layer tear; type B2, a partial\u2010thickness articular\u2010sided tear with extensive posterior delamination; and type C, extensive degeneration with multiple longitudinal bursal\u2010sided tears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The incidence of posterior delamination is extremely high, and most of these lesions are missed if one is viewing from just the posterior portal. Differential rotator cuff portals are needed to appreciate and treat posterior delamination. Patterns of delamination can be classified according to surgical repair strategy. It is important to recognize that the rotator cable may delaminate from the cuff and not to mistake it for a \u201cretracted\u201d articular layer, as previously described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, prospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2013.08.021","type":"journal-article","created":{"date-parts":[[2013,10,24]],"date-time":"2013-10-24T22:00:11Z","timestamp":1382652011000},"page":"1740-1747","source":"Crossref","is-referenced-by-count":51,"title":["Is Posterior Delamination in Arthroscopic Rotator Cuff Repair Hidden to the Posterior Viewing Portal?"],"prefix":"10.1002","volume":"29","author":[{"given":"Yung","family":"Han","sequence":"first","affiliation":[{"name":"Madi Hospital Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin\u2010Hyup","family":"Shin","sequence":"additional","affiliation":[{"name":"Madi Hospital Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang\u2010Woo","family":"Seok","sequence":"additional","affiliation":[{"name":"Madi Hospital Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang\u2010Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Madi Hospital Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung\u2010Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Madi Hospital Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,11,1]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511406395"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200706000-00013"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.E.00003"},{"key":"e_1_2_3_5_2","first-page":"43","article-title":"Functional and anatomical results after rotator cuff repair","author":"Gazielly D.F.","year":"1994","journal-title":"Clin Orthop Relat Res."},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00512"},{"key":"e_1_2_3_7_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.D.02035"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.01.005"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.1067\/mse.2001.112882"},{"key":"e_1_2_3_10_2","first-page":"603","article-title":"Delamination observed in full\u2010thickness rotator cuff tears","volume":"29","author":"Matsuki K.","year":"2005","journal-title":"Shoulder Joint (Katakansetsu)"},{"key":"e_1_2_3_11_2","doi-asserted-by":"publisher","DOI":"10.1067\/mse.2002.122272"},{"key":"e_1_2_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2009.12.020"},{"key":"e_1_2_3_13_2","doi-asserted-by":"crossref","unstructured":"Kim SH Ha KI Ahn JH Park JH. Differential arthroscopic portal placement for rotator cuff repair.Arthroscopy2002;18:E43. Available online atwww.arthroscopyjournal.org.","DOI":"10.1053\/jars.2002.29941"},{"key":"e_1_2_3_14_2","first-page":"667","article-title":"Subscapular muscle transposition for repair of chronic rotator cuff tears","volume":"154","author":"Cofield R.H.","year":"1982","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_3_15_2","first-page":"144","article-title":"Fluoroscopic comparison of kinematic patterns in massive rotator cuff tears. A suspension bridge model","author":"Burkhart S.S.","year":"1992","journal-title":"Clin Orthop Relat Res."},{"key":"e_1_2_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(05)80288-9"},{"key":"e_1_2_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(05)80496-7"},{"key":"e_1_2_3_18_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20120822-21"},{"key":"e_1_2_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2103-6"},{"key":"e_1_2_3_20_2","unstructured":"Costic RS Brucker PU Smolinski PJ Gilbertson LG Rodosky MW. Arthroscopic double row anchor repair of full thickness rotator cuff tear: Footprint restoration and biomechanical properties. Presented at the Annual Meeting of the Orthopaedic Research Society Chicago IL March 19\u201022 \u00a02006."},{"key":"e_1_2_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2006.09.010"},{"key":"e_1_2_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2006.09.011"},{"key":"e_1_2_3_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511415660"},{"key":"e_1_2_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.02.018"},{"key":"e_1_2_3_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0730-3"},{"key":"e_1_2_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(05)70213-3"},{"key":"e_1_2_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.08.016"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806313009237?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806313009237?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2013.08.021","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2013.08.021","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2013.08.021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T08:51:34Z","timestamp":1773564694000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2013.08.021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11]]},"references-count":26,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["10.1016\/j.arthro.2013.08.021"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2013.08.021","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11]]}}}