Clinical, Radiographic, and Surgical Presentation of Subscapularis Tendon Tears: A Retrospective Analysis of 139 Patients

Naimark, Micah; Zhang, Alan L.; Leon, Isabella; Trivellas, Andromahi; Benjamin, C.

doi:10.1016/j.arthro.2015.11.019

Cited by 28 publications

(18 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 25 , 26 It has recently been suggested that tear size correlates to MR imaging sensitivity, with larger tears having higher sensitivity than smaller tears. 10 , 27 …”

Section: Diagnosismentioning

confidence: 99%

“…Knowledge of presentation, detection, and repair of subscapularis tears are paramount for any practising orthopaedist who treats common shoulder conditions, as these lesions are at times identified on diagnostic shoulder arthroscopy or during repair of the posterosuperior rotator cuff or associated biceps pathology that are missed on pre-operative imaging. 7 - 10 The focus of this review is on arthroscopic management of tears of the subscapularis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Subscapularis tendon tears

Lenart¹,

Ticker

2017

EFORT Open Reviews

View full text Add to dashboard Cite

Tears of the subscapularis tendon have been under-recognised until recently. Therefore, a high index of suspicion is essential for diagnosis.A directed physical examination, including the lift-off, belly-press and increased passive external rotation can help identify tears of the subscapularis.All planes on MR imaging should be carefully evaluated to identify tears of the subscapularis, retraction, atrophy and biceps pathology.Due to the tendency of the tendon to retract medially, acute and traumatic full-thickness tears should be repaired. Chronic tears without significant degeneration should be considered for repair if no contraindication exists.Arthroscopic repair can be performed using a 30-degree arthroscope and a laterally-based single row repair; one anchor for full thickness tears ⩽ 50% of tendon length and two anchors for those ⩾ 50% of tendon length.Biceps pathology, which is invariably present, should be addressed by tenotomy or tenodesis.Timing of post-operative rehabilitation is dictated by the size of the repair and the security of the repair construct. The stages of rehabilitation typically involve a period of immobilisation followed by range of movement exercises, with a delay in active internal rotation (IR) and strengthening in IR.Cite this article: EFORT Open Rev 2017;2:484–495. DOI: 10.1302/2058-5241.2.170015

show abstract

“… 25 , 26 It has recently been suggested that tear size correlates to MR imaging sensitivity, with larger tears having higher sensitivity than smaller tears. 10 , 27 …”

Section: Diagnosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Subscapularis tendon tears

Lenart¹,

Ticker

2017

EFORT Open Reviews

View full text Add to dashboard Cite

show abstract

“…As such, full thickness tears are generally indicated for surgery [8, 9]. While a thorough physical exam is important, the sensitivity and tear size correlation of clinical exam are inferior to the sensitivity of MRI (100% in full thickness tears) [10]. Further, the reported sensitivity of exam maneuvers is variable in the literature, with Naimark et al reporting a 61% sensitivity with the belly-press maneuver and 63% with the lift-off test [10]; Barth et al suggest a superior sensitivity with the bear-hug maneuver (60%), while other special exams had only 40% sensitivity [11].…”

Section: Introductionmentioning

confidence: 99%

“…While a thorough physical exam is important, the sensitivity and tear size correlation of clinical exam are inferior to the sensitivity of MRI (100% in full thickness tears) [10]. Further, the reported sensitivity of exam maneuvers is variable in the literature, with Naimark et al reporting a 61% sensitivity with the belly-press maneuver and 63% with the lift-off test [10]; Barth et al suggest a superior sensitivity with the bear-hug maneuver (60%), while other special exams had only 40% sensitivity [11]. Nonetheless, isolated rotator cuff injury to the subscapularis is a rare occurrence that necessitates high clinical suspicion, particularly in the setting of the classic forced abduction-external rotation injury mechanism [8, 12, 13].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous, Bilateral Acute Subscapularis Ruptures and Their Arthroscopic Management

Schwartz

Wilson

Hammond

2019

Case Reports in Orthopedics

View full text Add to dashboard Cite

We present the first known case of bilateral, acute ruptures of the subscapularis tendons following a bicycle accident in a 43-year-old male. He underwent right shoulder arthroscopic, anatomic subscapularis tendon repair two weeks postinjury, with the left side staged for surgical treatment six weeks after the index procedure. Postoperatively, the patient remained in a sling for 6 weeks before advancing with therapy protocols. The interval between arthroscopic treatments allowed for independence with activities of daily living and focused, early therapy for each shoulder. This approach yielded a right-sided constant score of 89 and subjective shoulder value of 90%; the left side was 87 and 90%, respectively, at 33 months postoperatively. The patient’s only postoperative complaint was slightly diminished external rotation, a near-universal limitation after unilateral repair. This represents a successful outcome that balances functional independence, concentrated rehabilitation, and adherence to safe indications for primary repair. While bilateral traumatic shoulder injuries in a young person is a rare clinical entity, early and staged treatment can lead to good patient outcomes.

show abstract

“…Uglavnom su traumatske, nalazimo ih u mlađoj i aktivnijoj populaciji, te kod prednje luksacije ramena starijih ljudi. Mehanizam ozljede koji dovodi do rupture SSC-a je forsirana vanjska rotacija ruke uz otpor ili ekstenzija ruke koja se nalazi u abdukciji [27][28][29][30][31][32] . U kliničkoj slici dominira prednja i anterolateralna bolnost, ograničenje aktivne, a uz razvoj kontrakture i pasivne pokretljivosti ramena, znaci instabiliteta i ozljede CLMBB-a, te u slučaju potpune rupture i povećan pasivni opseg vanjske rotacije ozlijeđenog ramena.…”

unclassified

Artroskopsko liječenje oštećenja tetive subskapularisa

Matejčić

Lekić

2020

Med. Flum. (Online)

View full text Add to dashboard Cite

Cilj: prezentacija principa, tehnike i rezultata artroskopskog liječenja oštećene tetive subskapularisa. Ispitanici i metode: u razdoblju od 1. siječnja 2015. do 1. siječnja 2019. učinili smo 289 operacija ramena zbog oštećenja tetiva rotatorne manžete. Lezije tetive subskapularisa podijelili smo po Lafosseu i liječili artroskopski ili artroskopski asistirano. Analizirali smo rezultate isključivo artroskopskog liječenja 31 dostupnog pacijenta s lezijom tetive subskapularisa kojima je od operacije do procjene prošlo 6 i više mjeseci. Pacijenti su ispitani o prije i poslijeoperacijskim mogućnostima i tegobama po upitnicima Oxford shoulder score (OSS) i Subjective shoulder value (SSV). Rezultati: kod 89 slučajeva (30,79 %) našli smo oštećenje tetive subkapularisa od kojih 8 izoliranih (2,76 % svih lezija manžete) i 81 udružen s oštećenjem ostalih tetiva manžete. Kod 72 pacijenta (80,9 %) učinili smo artroskopsku operaciju, a u 17 slučajeva otvorenu uz artroskopsku asistenciju. 31 dostupan pacijent iz grupe artroskopski operiranih procijenjen je 17,96 ± 8,25 mjeseci od operacije upitnicima Oxford shoulder score i Subjective shoulder value (odziv 43,05 %). Oxford shoulder score značajno se povećao s 14,19 preoperativno na 36,74 postoperativno (p = 0,002). Subjective shoulder value također se značajno povećao s 27,32 na 82,33 (p << 0,001). Zaključak: artroskopsko liječenje oštećenja tetive subskapularisa, izolirano ili udruženo s ostalim lezijama manžete, predstavlja siguran i efikasan način liječenja s odličnim rezultatima.

show abstract

Clinical, Radiographic, and Surgical Presentation of Subscapularis Tendon Tears: A Retrospective Analysis of 139 Patients

Cited by 28 publications

References 24 publications

Subscapularis tendon tears

Subscapularis tendon tears

Simultaneous, Bilateral Acute Subscapularis Ruptures and Their Arthroscopic Management

Artroskopsko liječenje oštećenja tetive subskapularisa

Contact Info

Product

Resources

About