Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?

Abstract

Background:Rotator cuff tears are a common cause of shoulder pain and dysfunction. More recently, there has been a renewed interest in understanding the subscapularis tears. There are multiple articles in the literature showing the short term results of isolated subscapularis tendon repair. However, the midterm and long term outcome studies for arthroscopic subscapularis repair are few. This study evaluates the functional outcome after arthroscopic subscapularis repair.Materials and Methods:The records of 35 patients who underwent an arthroscopic subscapularis repair between May 2008 and June 2012 were included in this retrospective study. The records of all patients were reviewed. There were 22 males and 13 female patients with mean age of 58.2 years (range 41-72 years). All patients had a complete history, physical examination, and radiographs of their shoulders. Visual analogue scale (VAS), range of movements, power of cuff muscles, and modified University of California at Los Angeles (UCLA) score were assessed.Results:The mean followup was 2.8 years (range 2-4 year). Functional outcome after arthroscopic subscapularis repair has an excellent outcome as analysed by clinical outcome, VAS score and UCLA score. Results were analyzed and had statistically significant values. The VAS for pain improved significantly (P < 0.001), and the mean modified UCLA score improved significantly (P < 0.001) from 14.24 ± 4.72 preoperatively to 33.15 ± 2.29 at 2 years postoperative. According to the UCLA system, there were 22 excellent, 11 good, and 2 fair results. Around 95% of patients returned to their usual work after surgery.Conclusion:At a median followup of 2 years, 95% of patients had a good to excellent result after an arthroscopic subscapularis tendon repair. We conclude that the midterm results show that arthroscopic subscapularis repair remains a good option for the treatment of patients with subscapularis tendon repair.

Arthroscopic Subscapularis Tendon Repair Using the Lasso-Loop Technique Through Anterolateral Viewing Portal

“… 4 The incidence of subscapularis tears was shown to be between 3% and 13% by autopsy and cadaveric studies. 5 Subscapularis tears are hard to access, and they require advanced surgical techniques. 6 …”

Subscapularis tear classification implications regarding treatment and outcomes: consensus decision-making

“…Some studies reported the result of the subscapularis repair and attempted to correlate with tear classification. 1 , 3 , 6 , 35 Rhee et al used 2 different classification systems: Lafosse et al and Yoo et al. He found neither classification helpful in predicting the outcome of treatment.…”

Arthroscopic Subcoracoid Decompression, Coracoplasty, and Subscapularis Repair for Subscapularis Tears in the Setting of Subcoracoid Impingement

“…There have been numerous techniques published regarding arthroscopic treatment of subscapularis pathology; however, we believe that this technique is both simple and reproducible with excellent results, as reported by Katthagen et al and others. [9][10][11][12][13][14][15][16][17][18] Additionally, our stepwise approach with decompression of the subcoracoid space allows for safe manipulation of the subscapularis tendon in proximity to the neurovascular structures medially and inferiorly.…”

“…and others. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 Additionally, our stepwise approach with decompression of the subcoracoid space allows for safe manipulation of the subscapularis tendon in proximity to the neurovascular structures medially and inferiorly.…”