Effect of Subscapularis Tears on Functional Scores of Patients Undergoing Rotator Cuff Repair

Abstract

Objective: To evaluate the influence of partial- and full-thickness upper third subscapularis tendon tears on the functional scores of patients undergoing arthroscopic rotator cuff repair. Methods: Patients who underwent arthroscopic rotator cuff repair were divided into three groups according to the subscapularis tendon condition: intact, partial-thickness tear, or full-thickness upper third tear. Functional scores were compared among groups. Second, the influence of biceps and infraspinatus tears on the scores was tested using multivariate regression analysis. Results: We evaluated 307 shoulders in 297 patients. Full-thickness upper third subscapularis tears presented significantly worse scores than intact tendons. Partial-thickness tears had scores that did not differ significantly from those of the other groups. Patients with full-thickness upper third tears presented a greater rate of injured and unstable biceps tendons. The multivariate analysis showed that biceps and infraspinatus tendon tears did not influence the scores or the intergroup comparison. Conclusion: Full-thickness upper third subscapularis tendon tears presented worse functional scores than intact subscapularis tendons among patients undergoing posterosuperior rotator cuff repair. Patients with full-thickness subscapularis tears were more likely to suffer biceps tears, but this fact did not influence functional scores. Level of Evidence I; Clinical randomized trial

Arthroscopic Subscapularis Tendon Repair Using the Mason-Allen Technique

“…Like Malavolta et al discovered, our results revealed that patients with a subscapularis lesion present poor quality of function according to UCLA, ASES, and VAS scores 16 . They also evaluated the influence of upper third subscapularis tendon tears.…”

Reliability, validity, and responsiveness of a novel subscapularis outcome score: the Baltimore Orthopedic Subscapularis Score

“…Two studies found that the difference in ASES score between full thickness subscapularis tears and normal tendons was less than the ASES MCID. 16 , 24 Similarly, Park et al 23 found no statistically significant difference in preoperative ASES score between intact, partial, and partial-to-full subscapularis tendon tears. Therefore, considering there is no gold standard subscapularis-specific survey, a criterion validity was not reported in this study.…”

Repair of Lafosse I subscapularis lesions brings no benefit in anterosuperior rotator cuff reconstruction

“…Interestingly, 11 patients with a Lafosse type II SSC tear repair had a significantly higher mean postoperative ASES score than the 17 patients with a Lafosse type I tear. A new retrospective cohort study looked at the influence of an SSC upper third tear on preoperative American Shoulder and Elbow Surgeons (ASES) scores of patients undergoing arthroscopic posterosuperior RC repair [36]. Patients with full‐thickness SSC tears had significantly worse preoperative ASES scores compared to those with intact tendons, whereas the scores for partial SSC lesion patients were neither significantly different to the intact nor the completely torn SSC tendons.…”