Risk factors of chronic subscapularis tendon tear

Abstract

Background: Chronic subscapularis tendon tear (SBT) is a degenerative disease and a common pathologic cause of shoulder pain. Several potential risk factors for chronic SBT have been reported. Although metabolic abnormalities are common risk factors for degenerative disease, their potential etiological roles in chronic SBT remains unclear. The purpose of this study was to investigate potential risk factors for chronic SBT, with particular attention to metabolic factors.Methods: This study evaluated single shoulders of 939 rural residents. Each subject undertook a questionnaire, physical examinations, blood tests, and simple radiographs and magnetic resonance imaging (MRI) evaluations of bilateral shoulders. Subscapularis tendon integrity was determined by MRI findings based on the thickness of the involved tendons. The association strengths of demographic, physical, social, and radiologic factors, comorbidities, severity of rotator cuff tear (RCT), and serologic parameters for SBT were evaluated using logistic regression analyses. The significance of those analyses was set at p<0.05.Results: The prevalence of SBT was 32.2% (302/939). The prevalence of partial- and full-thickness tears was 23.5% (221/939) and 8.6% (81/939), respectively. The prevalence of isolated SBT was 20.2% (190/939), SBT combined with supraspinatus or infraspinatus tendon tear was 11.9% (112/939). In multivariable logistic regression analysis, dominant side involvement (p<0.001), manual labor (p=0.002), diabetes (p<0.001), metabolic syndrome (p<0.001), Retraction degree of Patte tendon (p<0.001), posterosuperior RCT (p=0.010), and biceps tendon injury (p<0.001) were significantly associated with SBT.Conclusion: Metabolic syndrome is a potential risk factor for SBT, as are these factors: overuse activity, diabetes, posterosuperior RCT, increased retraction of posterosuperior rotator cuff tendon, and biceps tendon injury.

Arthroscopic Repair of Large Subscapularis Tear Over the First Facet

“…With improvements in shoulder arthroscopy, information about SSC has accumulated. 22,33,41 However, the consensus on large SSC tears and retears remains inconclusive 25,42 ; furthermore, long-term outcome studies of arthroscopic repair for large SSC tears are limited. 35 Previous studies have regarded large SSC tears as follows: (1) complete or full-thickness tears without a clear definition or (2) Lafosse type III and IV tears (upper two-thirds or whole SSC tears).…”

“…With improvements in shoulder arthroscopy, information about SSC has accumulated. 22,33,41 However, the consensus on large SSC tears and retears remains inconclusive 25,42 ; furthermore, long-term outcome studies of arthroscopic repair for large SSC tears are limited. 35…”

“…28,38,42 Furthermore, surgical indications, techniques, and outcomes of SSC tears have been well documented along with the improvement of shoulder arthroscopy. 5,11,14,16,22,29,33,41…”

“…Previously regarded as a forgotten tendon, the subscapularis (SSC) has recently received considerable attention. 5,16,22,33 The anatomic and biomechanical characteristics of SSC are being identified continually. 28,38,42 Furthermore, surgical indications, techniques, and outcomes of SSC tears have been well documented along with the improvement of shoulder arthroscopy.…”

Diagnostic Performance of Belly-Press Angle in Predicting the Severity of Subscapularis Tear

“…33,52 The incidence of the subscapularis tears combined with supraspinatus tears has been reported to be approximately 30% to 50%. 3-5,17,25,38 Diagnosis of subscapularis tears is becoming increasingly important because if the subscapularis tendon is not properly treated, the functional outcome will be poor even after the repair of supraspinatus and infraspinatus tears. 53…”