Double suture technique to delineate PASTA lesions.

A common method of treating PASTA (partial articular surface tendon avulsion) lesions involves completing the tear followed by arthroscopic repair. Frequently, the boundaries of the tear are difficult to determine from the bursal side with the use of a single marking stitch. Therefore, we describe a simple technique that allows the surgeon to reproducibly define the boundaries of the partial tear. Following a standard arthroscopic examination of the articular portion of the shoulder joint, the PASTA lesion is identified. A spinal needle is introduced and the most anterior and posterior aspects of the tear are marked by passing 2 sutures. Following a bursectomy, the 2 sutures that clearly define the boundaries of the tear are identified. The tear is then completed by "connecting the dots" outlined by the sutures and an arthroscopic repair is performed in the standard manner.