Arthroscopic repair of isolated subscapularis tears: clinical outcome and structural integrity with a minimum follow-up of 4.6 years

Hasler, Anita; Boyce, Glenn; Schallberger, Alex; Jost, Bernhard; Catanzaro, Sabrina; Gerber, Christian

doi:10.1016/j.jse.2019.03.024

Cited by 13 publications

(16 citation statements)

References 36 publications

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“…Nonetheless, if these data are used to consider conservative management, it should be interpreted in the light of the very good long-term results of isolated SSC tendon repair, which does not seem to be associated with a comparable development or enlargement of lesions of the other cuff elements. 19 We have also re-analyzed original data from our previous study assessing outcomes after arthroscopic SSC tendon repair, to assess whether repair is associated with a high secondary rupture rate of SS and IS tendons. 19 This analysis shows that out of 36 patients, only 2, 7 new, partial IS/SS lesions (=25%), could be observed at the latest follow-up of mean 8.6 years.…”

Section: Discussionmentioning

confidence: 99%

“… 19 We have also re-analyzed original data from our previous study assessing outcomes after arthroscopic SSC tendon repair, to assess whether repair is associated with a high secondary rupture rate of SS and IS tendons. 19 This analysis shows that out of 36 patients, only 2, 7 new, partial IS/SS lesions (=25%), could be observed at the latest follow-up of mean 8.6 years. These results suggest that repair of the SSC might have a protective effect on the other (posterior-superior) muscle tendon units.…”

Section: Discussionmentioning

confidence: 99%

“…Both arthroscopic and open SSC repairs have yielded excellent and durable clinical improvement over the preoperative state after unsuccessful conservative management. 3 , 31 , 34 , 35 , 37 , 39 , 4 , 5 , 6 , 7 , 8 , 9 , 11 , 12 , 14 , 16 , 19 , 20 , 24 , 25 , 26 , 31 , 34 , 35 , 37 , 39 In small- to moderate-sized full-thickness tears of the supraspinatus (SS) and infraspinatus (IS) tendons treated conservatively, tear size, atrophy, and fatty muscle infiltration have been shown to progress so that the tears may become irreparable over time. 23 , 32 , 36 , 43 Analysis of the natural history of SS tendon tears showed a 50% likelihood of tear progression after 4 years.…”

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confidence: 99%

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Nonoperatively managed small- to medium-sized subscapularis tendon tears: magnetic resonance imaging evaluation with a minimum of 5 years of follow-up

et al. 2022

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Background Isolated or combined subscapularis (SSC) tendon tears are frequently found in patients with shoulder pain. The purpose of this study was to evaluate the structural changes associated with SSC tear in a consecutive series of patients with nonoperatively treated small size to midsize SSC tendon tears using magnetic resonance imaging (MRI). Methods In this retrospective case series, all patients with an isolated or combined SSC tendon tear treated nonoperatively between 1999 and 2019 were identified from our MRI and clinical databases. Twenty-one patients with a mean age of 52.6 years (range 26.6-64.8, standard deviation 9.3) with a second MRI scan at a minimum of 5 years of follow-up were enrolled. The mean follow-up was 8.6 years (range 5.6-12.6, standard deviation 1.8). Initial and last follow-up MRI scans were used to determine concomitant cuff lesions, size of the SSC tear, fatty infiltration of the SSC muscle, and biceps pathology. Results Five patients had an isolated SSC lesion; 7 patients had a concomitant tear of the supraspinatus, and 9 patients had a supraspinatus and anterior infraspinatus tendon tear. At diagnosis, 14 patients had a type 1 SSC lesion as classified by Lafosse et al, 4 patients had type 2, and 3 patients had type 3 lesions. Nineteen patients (90%) were found to have an SSC tear progression of at least one Lafosse grade ( P < .001); however, no tear had progressed to an irreparable type lesion (defined as Lafosse type 5). In addition, the size of SSC tendon tears increased significantly from 75 mm 2 to 228 mm 2 ( P < .001). At the final MRI scan, the grading of fatty infiltration increased by 1 grade in 4 cases and by 2 grades in 4 cases ( P = .042). At the final follow-up, in eight patients, the condition of the long head of biceps tendon was unchanged from the initial MRI; in nine patients, there was a newly subluxated biceps tendon, and in 6 patients, there was a newly ruptured long head of biceps tendon ( P < .001). Conclusion After a mean of 8.6 years, almost all nonoperatively treated SSC tendon tears had increased in size, but only one-third showed additional progression of muscle fatty degeneration on MRI scan. None of the SSC lesions became irreparable during the observation period.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Nonoperatively managed small- to medium-sized subscapularis tendon tears: magnetic resonance imaging evaluation with a minimum of 5 years of follow-up

et al. 2022

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“…Arthroscopic repair of subscapularis tears can be performed with excellent outcomes. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 Through the advancements of arthroscopic techniques, numerous investigators have proposed various techniques of varying complexity for repair of isolated subscapularis tears. 18 , 26 , 27 , 28 , 29 , 30 , 31 , 32 Van der Zwaal et al.…”

Section: Discussionmentioning

confidence: 99%

“… 9 , 10 Numerous studies have demonstrated good to excellent clinical results after an arthroscopic repair and, therefore, recommend repair of partial or full-thickness subscapularis tears in shoulders that have failed conservative treatment. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 The Lafosse classification grading system, which classifies subscapularis tear morphology, is a useful tool to help guide overall treatment for the patient ( Table 1 ). 15 , 25 Since the advent and advancement of arthroscopic techniques, many techniques have recently evolved for arthroscopic subscapularis repair.…”

Section: Introductionmentioning

confidence: 99%

Single-Portal, Single-Anchor Repair of a Superior Third Subscapularis Tear Using a Self-Punching Knotless Soft Suture Anchor

Sol¹,

Guzman²,

Yin³

et al. 2021

Arthroscopy Techniques

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Numerous techniques exist for arthroscopic subscapularis repair with varying degrees of complexity based on tear morphology, all of which have established satisfactory outcomes in function and patient satisfaction. Arthroscopic subscapularis repair can require several working portals and suture anchors, increasing both technical complexity and operative time. This Technical Note describes an arthroscopic repair of a superior one-third subscapularis tear using a self-punching knotless soft suture anchor through a single anterior working portal. Thus, we offer a unique approach to arthroscopic repair of superior one-third subscapularis tears that is time-saving, reproducible, and highly efficient while minimizing iatrogenic damage and postoperative complications.

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Arthroscopic Repair of Subscapularis Tendon Tear

Lin

2023

Arthroscopy and Endoscopy of the Shoulder

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Arthroscopic repair of isolated subscapularis tears: clinical outcome and structural integrity with a minimum follow-up of 4.6 years

Cited by 13 publications

References 36 publications

Nonoperatively managed small- to medium-sized subscapularis tendon tears: magnetic resonance imaging evaluation with a minimum of 5 years of follow-up

Nonoperatively managed small- to medium-sized subscapularis tendon tears: magnetic resonance imaging evaluation with a minimum of 5 years of follow-up

Single-Portal, Single-Anchor Repair of a Superior Third Subscapularis Tear Using a Self-Punching Knotless Soft Suture Anchor

Arthroscopic Repair of Subscapularis Tendon Tear

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