Comparison of Open Versus Arthroscopic Repair for Subscapularis Tendon Tears With or Without Concomitant Supraspinatus Tendon Tears

Gedikbaş, Mete; Öztürk, Tahir; Erpala, Firat; Zengin, Eyüp

doi:10.1177/23259671221120662

Cited by 5 publications

(10 citation statements)

References 44 publications

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“…Isolated SSC tears are relatively rare compared with posterosuperior cuff tears, and there is limited research on isolated SSC repairs in the literature. 1 , 32 , 36 , 37 Since the study by Burkhart and Tehrany 5 on AISR, subsequent studies have consistently demonstrated significant improvements in PROs and ROM, 4 , 14 , 16 , 24 , 34 which align with the findings from our study. Among previous studies, Seppel et al 38 and Liu et al 28 presented long-term outcomes after the repair of isolated SSC tears, with mean follow-up times of 98.4 and 120 months, respectively, while our study presents midterm follow-up results (56.7 ± 3.3 months) in the largest sample size 36 , 37 , 41 of patients (N = 77).…”

Section: Discussionsupporting

confidence: 90%

Clinical Outcomes and Tendon Healing After Arthroscopic Isolated Subscapularis Tendon Repair: Results at Midterm Follow-up

Kilic,

Zuk,

Ardebol

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: Few studies have reported clinical outcomes and tendon healing rates after arthroscopic isolated subscapularis (SSC) repair (AISR). Purpose/Hypothesis: The primary purpose of this study was to evaluate clinical outcomes and tendon healing after AISR. It was hypothesized that AISR would result in satisfactory clinical outcomes along with a high rate of tendon healing at the midterm follow-up. The secondary purpose was to assess the influence of tear size and muscle atrophy on SSC tendon healing and patient-reported outcomes. It was hypothesized that both would be negatively correlated with healing but would have no effect on clinical outcomes . Study Design: Case series; Level of evidence, 4. Methods: A retrospective analysis was conducted on prospectively collected data for 77 patients who underwent primary AISR between 2011 and 2021 at a single institution, with a minimum 2-year postoperative follow-up for all patients. Functional outcomes were assessed using the American Shoulder and Elbow Surgeons (ASES) score, the Subjective Shoulder Value (SSV), and the visual analog scale for pain. Repair techniques and concomitant procedures were also collected. SSC tendon healing was evaluated via ultrasound at the final follow-up. Linear regression analysis was performed to determine factors affecting SSC healing. Results: The mean follow-up was 58.1 ± 3.3 months. ASES scores significantly improved from 41.5 to 81.6, and the SSV improved from 38.2 to 80.5 ( P < .01 for both). Among the 40 patients (51.9%) who underwent postoperative ultrasound, 87.5% showed complete tendon healing. There were no significant differences in outcome scores between healed and unhealed tendons. Increased muscle atrophy and larger tears were correlated with failure of SSC healing (β = −0.285 [ P = .015] and β = −0.157 [ P = .045], respectively). Conclusion: Improved clinical outcomes and an overall high rate of tendon healing were seen at the midterm follow-up after AISR. Smaller tear sizes with less muscle atrophy were correlated with improved tendon healing. However, even when the tendon incompletely healed, the procedure improved functional outcomes.

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Section: Discussionsupporting

confidence: 90%

Clinical Outcomes and Tendon Healing After Arthroscopic Isolated Subscapularis Tendon Repair: Results at Midterm Follow-up

Kilic,

Zuk,

Ardebol

et al. 2024

Orthopaedic Journal of Sports Medicine

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“…They observed that the side impacted was substantially different among both groups (Pvalue 0.007), which was contrary to our observations. They noted that tendon tear was considerably different among both studied groups; isolated were substantially lower in AS than open group (1:7) but combined were considerably higher in AS than open group (35:27) (P-value = 0.026) [13] .…”

Section: Discussionmentioning

confidence: 94%

“…In 1954, Hauser conducted the initial investigation into ST repair. Despite the fact that ST injuries have been documented historically, there aren't many studies on how to treat them because to the tendon's proximity to vital neurovascular systems and its lower risk of injury compared to the other tendons that make up the rotator cuff [13] .…”

Section: Discussionmentioning

confidence: 99%

Subscapularis Tear Repair Arthroscopic vs Open Surgery

Attia

H.Ahmed

El-Begawy

2023

Benha Journal of Applied Sciences

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Background: The largest rotator cuff tendon, the subscapularis, rotates the glenohumeral joint internally. This study's objective was to compare the arthroscopic versus the open technique outcomes in subscapularis tear repair. Methods: This prospective study comprised 30 patients who had a subscapularis tear and needed either arthroscopic or open surgery for repair. The study was done in Benha university hospitals and Ahrar teaching hospital from November 2020 to February 2023. Patients were split into 2 groups: Arthroscopic group: 15 were treated by arthroscopic surgery. Open surgery group: 15 were treated with open surgery. Results: The arthroscopic group had a higher percentage of combined tears and affected the right side more often, while the open surgery group had a higher percentage of isolated tears and affected the left side more often. The arthroscopic group had more postoperative pain, but fewer complications than the open surgery group. Preoperative and postoperative clinical assessments showed substantial changes among groups of the study concerning the constant score, UCLA score, and results of belly press test. The arthroscopic group had more positive results in belly press tests and lift off after operation. The two groups had similar outcomes in terms of post-surgical complications and duration of follow up. Conclusions: In terms of motion range and functional results, arthroscopic treatment may be preferable to open repair. While there are still rare cases when open repair surgery makes sense, particularly when arthroscopic options are restricted.

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“…However, whether it would be helpful to repair the SSC tear is not clear, since most of the patients were combined with supraspinatus and infraspinatus tendon tears in our series [36, 37]. InSSC tears might be the cause of unexplained anterior shoulder pain [36, 38, 39].…”

Section: Discussionmentioning

confidence: 99%

The prevalence, classification, radiological and arthroscopic findings of intratendinous subscapularis tears

Lin

Zhang

Cui

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeTo investigate the clinical characteristics of intratendinous subscapularis (inSSC) tears. MethodsRetrospectively, 69 patients with arthroscopically confirmed inSSC tears were identified from 2018 to 2019. Preoperatively and at final follow‐up, thorough physical examination was performed and clinical outcomes (American Shoulder and Elbow Surgeons [ASES] score; University of California, Los Angeles [UCLA] score; visual analogue scale [VAS] for pain; and Simple Shoulder Test [SST]) were recorded. Features of pre‐operative magnetic resonance image (MRI) such as high signalling within the tendon substance, communication to the bicipital groove and long head of biceps tendon (LHBT) lesions were investigated. Characteristics of arthroscopic view were investigated. Bear‐hug and internal rotation resistance test at 90° abduction and external rotation (IRRT90°) test were used to assess the SSC strength. ResultsThe mean follow‐up was 2.4 (2–3) years. The prevalence of arthroscopically confirmed inSSC tears was 69/675 (10.2%) among arthroscopic rotator cuff repairs. Pre‐operative physical examination found positive IRRT90° and bear‐hug test in 41/60 (68.3%) and 42/69 (60.8%) patients, respectively. The Cohen kappa coefficient was interpreted to be substantial for the evaluation of all MRI parameters. According to the conditions of LHBT, inSSC tears were classified into 3 types: type I: without LHBT subluxation and tear; type II: with LHBT subluxation or tears and type III: with LHBT dislocation. At final follow‐up, mean ASES, UCLA, VAS, and SST scores improved significantly from mean of 50.6 ± 14.7, 19.4 ± 3.07, 6.2 ± 2.0, and 6.1 ± 2.5 to mean of 90.7 ± 9.5, 32.2 ± 1.8, 1.4 ± 1.2 and 9.8 ± 2.2, respectively (P < 0.001). Bilateral symmetric strength was found by bear‐hug and IRRT90° test in all patients postoperatively. ConclusionUnderstanding features of pre‐operative MRI, physical examination and arthroscopic view is helpful to identify inSSC tears. Arthroscopic repair yielded satisfactory clinical outcomes in patients with inSSC tears. Level of evidenceLevel IV.

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Comparison of Open Versus Arthroscopic Repair for Subscapularis Tendon Tears With or Without Concomitant Supraspinatus Tendon Tears

Cited by 5 publications

References 44 publications

Clinical Outcomes and Tendon Healing After Arthroscopic Isolated Subscapularis Tendon Repair: Results at Midterm Follow-up

Clinical Outcomes and Tendon Healing After Arthroscopic Isolated Subscapularis Tendon Repair: Results at Midterm Follow-up

Subscapularis Tear Repair Arthroscopic vs Open Surgery

The prevalence, classification, radiological and arthroscopic findings of intratendinous subscapularis tears

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