Combined tears of the subscapularis and supraspinatus tendon: clinical outcome, rotator cuff strength and structural integrity following open repair

Abstract

Open repair of combined anterosuperior rotator cuff tears achieved good postoperative results despite a residual rotator cuff strength deficit. Combined supraspinatus-/full-thickness subscapularis tears achieved equal clinical and radiographic results compared with supraspinatus-/partial-thickness subscapularis tears.

Recovery of subscapularis and shoulder function following arthroscopic treatment of isolated anterior and combined anterosuperior rotator cuff lesions

“…At final follow-up, all patients achieved a significant gain in Constant Score and in the assessment of subscapularis function. The results are comparable to those published in literature [2,8].…”

“…The authors could not show significant differences in age-and gender-adapted Constant Score in these groups. Bartl et al compared patients with partial or total subscapularis lesion combined with a full-thickness supraspinatus tear [2]. No significant differences could be evaluated in the absolute or relative Constant Score.…”

“…Anterior and anterosuperior cuff tears have gained more attention in the past years [2,8,[20][21][22]. Since the subscapularis tendon is the anterior part of the transversal ''force couple'', it is important for a satisfactory shoulder function [4].…”

“…Isolated anterior rotator cuff tears are quite seldom and mainly caused by traumatic events, whereas anterosuperior cuff tears that involve the subscapularis and supraspinatus tendon are mostly of degenerative origin and occur more frequently [1][2][3]. As the subscapularis is an important internal rotator and stabilizes the shoulder against anterior forces, the fullest possible recovery is fundamental [4].…”

Partial and Full-Thickness RCT: Modern Repair Techniques

“…Although others have proposed an alternative pathoanatomy for this arthroscopic finding, the reduction of the tissue that represents the comma tissue to the remnant subscapularis has been shown to recreate the intraarticular aspect of the torn subscapularis while concurrently reducing the leading edge of the supraspinatus [85]. Short-term and long-term results of isolated subscapularis and combined rotator cuff tears involving the subscapularis have consistently been shown to lead to good or excellent results in the vast majority of cases, with structurally intact repairs evaluated via ultrasound and magnetic resonance imaging reported as high as 93% [86][87][88][89][90][91][92]. Additionally, the reduction of the comma tissue to the torn subscapularis tendon can help reduce the leading edge of supraspinatus tears when found concomitantly.…”