Outcomes of Non-Operative versus Operative Management for Partial Articular-Sided Tendon Avulsion (PASTA) in Athletes: A Systematic Review | ||
| The Egyptian Orthopaedic Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 27 September 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/eoj.2025.392432.1049 | ||
| Authors | ||
| Mohamed Mamdouh Salah El Din Sherif1; Matta Nashat Nazeer Dreass* 2; Sherif Sameh Ghobrial Elias3 | ||
| 1Consultant of Orthopedic Surgery, Sahel Teaching Hospital,Cairo, Egypt. | ||
| 2Department of Orthopedics, Sahel Teaching Hospital, Cairo, Egypt. | ||
| 3Resident of Orthopedic Surgery, Sahel Teaching Hospital,Cairo, Egypt. | ||
| Abstract | ||
| Background: Partial-thickness rotator cuff tears (PTRCTs), as well as Partial Articular-Sided Tendon Avulsion (PASTA) lesions, are common concerns that contribute substantially to shoulder pain, limitations in activities of daily living (ADLs) and earning a living. Objectives: The purpose of this study was to compare outcomes following non-operative and operative management for PASTA in athletes. Methods: This systematic review and meta-analysis was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and included 19 retrospective studies and 1 cohort study (2000–2023). Ten studies described operative interventions, and 10 described non-operative interventions. Searches were conducted using PubMed, Cochrane, Scopus, and Web of Science.The outcomes included Visual Analog Scale (VAS), Constant-Murley Score (CMS), forward elevation, external rotation, and American Shoulder and Elbow Surgeons (ASES) scores. The data analysis was conducted using RevMan 5.4 with subgroupanalysis and heterogeneity assessment using I² and the chi-square tests. Results: The studies included 6 operative and 4 non-operative studies reporting VAS scores, 5 operative and 5 non-operative studies reporting CMS scores, and 3 operative and 1 non-operative study reporting forward elevation values. Overall comparison showed many significant differences in the outcomes between the two management approaches. Operative techniques tended to yield improved functional results. Conclusions: Both non-operative and operative treatments are acceptable options for management of PASTA in athletes. Operative management techniques - chiefly trans-tendinous repair - had better functional outcomes than non-operative methods. All completion repair methods also provided functional results, indicating that further comparative evaluation and experiential research is warranted. | ||
| Keywords | ||
| patients` Outcomes; Non-Operative; Operative; PASTA | ||
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