Rupture of the subscapularis tendon after shoulder arthroplasty: Diagnosis, treatment, and outcome

Miller, Bruce S.; Joseph, Thomas; Noonan, Thomas J.; Horan, Marilee P.; Hawkins, Richard J.

doi:10.1016/j.jse.2005.02.013

Cited by 169 publications

(113 citation statements)

References 16 publications

(22 reference statements)

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“…In the primary setting, the most common rotator cuff tear is a subscapularis tear. Miller et al showed that the prevalence of postoperative subscapularis tear is 6 % and that all patients in their study required surgical repair [6]. However, this tear rate is likely higher in the revision setting.…”

Section: Instabilitymentioning

confidence: 89%

Management of complications after revision shoulder arthroplasty

Rahmi

Jawa

2015

Curr Rev Musculoskelet Med

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Complications after revision shoulder arthroplasty are similar to those in the primary setting which include instability, fracture, bone loss, infection, nerve injury, and loosening. Unlike in the primary setting, however, the rate of complications for revisions is significantly greater and the management is more complex because of overlapping complications and limited treatment options. Furthermore, there is a paucity of evidence-based literature to direct the management options in these patients. The purposes of this review are to broadly outline the major complications that are seen in revision shoulder arthroplasty and to provide general principles on how to recognize and approach these complex cases.

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Section: Instabilitymentioning

confidence: 89%

Management of complications after revision shoulder arthroplasty

Rahmi

Jawa

2015

Curr Rev Musculoskelet Med

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“…In case of severe internal rotation contracture, several authors recommend coronal Z-lengthening of the subscapularis [19]. We do not recommend this, as it is associated with an unacceptably high rate of secondary tear for a length gain generally <1 cm [19].…”

Section: Subscapularis Tenotomymentioning

confidence: 90%

“…After shoulder arthroplasty, it was shown that functional scores were significantly lower when the subscapularis was clinically deficient (on belly-press, lift-off or knitting test). Failure of subscapularis repair is not the only cause of subscapularis dysfunction, and several other causes have been reported: denervation during release, poor-quality tissue, inappropriate physical therapy or excess tension due to oversized components [15,18,19]. In cadaver studies of subscapularis repair techniques, mechanical pullout resistance was less in tendon-to-bone than tendon-to-tendon repair [20][21][22].…”

Section: Subscapularis Tenotomymentioning

confidence: 99%

“…In vivo, however, difference in recovery of subscapularis function according to repair method is unclear [15,[23][24][25][26]. Several dedicated studies of subscapularis [25,26] showed that structural integrity of the subscapularis tendon was not synonymous with optimal function, and some patients with subscapularis deficiency may remain asymptomatic [19,25,26]. After shoulder arthroplasty, partial subscapularis tear does not seem to impair functional outcomes [25,26].…”

Section: Subscapularis Tenotomymentioning

confidence: 99%

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Deltopectoral approach for shoulder arthroplasty: anatomic basis

Gadéa

Bouju

Berhouet

et al. 2015

International Orthopaedics (SICOT)

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“…Anterior cortical defects can compromise the subscapularis repair at the end of the procedure. Insufficiency of the subscapularis has been shown to result in a weakness with internal rotation on the one hand, while on the other hand there is evidence that an irreparable subscapularis tendon in reverse shoulder arthroplasty is associated with an increased risk of postoperative dislocation [3,10]. Eccentric humeral components with different degrees of posterior offset relative to the prosthetic stem allow for individual adjustment of posterior offset in order to avoid damage to the anterior cortex.…”

Section: Introductionmentioning

confidence: 99%

Effect of posterior offset humeral components on range of motion in reverse shoulder arthroplasty

Dedy

Stangenberg

Liem

et al. 2010

International Orthopaedics (SICOT)

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The purpose of this study was to evaluate the effect of eccentric humeral components with different degrees of posterior offset on range of glenohumeral motion in reverse shoulder arthroplasty. Uncemented PROMOS® reverse shoulder prostheses were implanted in eight human cadaveric shoulder specimens. Passive range of motion was evaluated with a robot-assisted shoulder simulator. Three movements were tested: abduction, anterior elevation and external rotation. Each specimen was tested with a customary reverse humeral component and two eccentric components with 3 and 6 mm of posterior offset respectively. Mean abduction was 81°(standard deviation [SD] 12) for the customary reverse components, 81°(SD 13) for the 3 mm eccentric and 82°(SD 15) for 6-mm eccentric implants. Mean anterior elevation was 68°( SD 13) in the regular group and 66°(SD 14) and 63°(SD 14) for 3-and 6-mm eccentric groups. With all configurations, 90°of external rotation were achieved without requiring more than 2 N·m of applied rotational moment. Although there was no statistically significant difference between the conventional and the eccentric implants, anterior elevation was decreased by almost 20°in three of eight shoulders with the posterior offset configurations. This was due to a conflict between the proximal humerus and the anterior aspect of the acromion or the coracoid. Although eccentric humeral components can be useful in reverse shoulder arthroplasty to avoid anterior cortical defects in individuals with pronounced humeral head posterior offset, a potential conflict between proximal humerus and scapula may have an unfavourable effect on range of anterior elevation. However, this observation is only true for the uncemented PROMOS® reverse prosthesis. Other reverse shoulder designs with posterior offset components are yet to be tested.

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Rupture of the subscapularis tendon after shoulder arthroplasty: Diagnosis, treatment, and outcome

Cited by 169 publications

References 16 publications

Management of complications after revision shoulder arthroplasty

Management of complications after revision shoulder arthroplasty

Deltopectoral approach for shoulder arthroplasty: anatomic basis

Effect of posterior offset humeral components on range of motion in reverse shoulder arthroplasty

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