Combined Subscapularis Tears in Massive Posterosuperior Rotator Cuff Tears

Park, Jin‐Young; Chung, Seok Won; Lee, Seoung-Joon; Cho, Hyoung-Weon; Lee, Jae Hyung; Lee, Junhee; Oh, Kyung-Soo

doi:10.1177/0363546515610552

Cited by 39 publications

(32 citation statements)

References 56 publications

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“…, 8 However, their presence associated with supraspinatus tear are observed in more than 50% of arthroscopic rotator cuff repairs 9 10 Furukawa et al 14 observed subscapularis tear in 69% of their series, the majority consisting of partial- (35%) or full-thickness upper third tears (25%). MRI presents low sensitivity in the detection of these tears, especially in partial-thickness ones, which makes difficult the adequate diagnosis and treatment 10 .…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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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

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Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…A previous study reported that 69% of large or massive tears were accompanied by subscapularis tears and many of these had concomitant complete rupture of the LHBT. 27) Park et al 28) showed that among patients who underwent arthroscopic repair for posterosuperior rotator cuff tears, patients with more than 50% of their subscapularis torn had a 43% retear rate, which was higher than in patients with less than 50% tears or no tears. Moreover, large subscapularis tears highlight the underlying decreases in both the cellularity of fibroblasts and the number of blood vessels that inhibit the healing capacity of a tissue.…”

Section: Discussionmentioning

confidence: 99%

Bridging Graft in Irreparable Massive Rotator Cuff Tears: Autogenic Biceps Graft versus Allogenic Dermal Patch Graft

Rhee

2017

Clin Orthop Surg

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BackgroundFew comparative studies have reported on the use of biologic grafts for irreparable massive rotator cuff tears. The purpose of this study was to assess the results of arthroscopic bridging graft in irreparable massive rotator cuff tears using an autogenic long head of biceps tendon (LHBT) or an allogenic dermal patch (ADP).MethodsWe retrospectively reviewed 24 patients treated using the LHBT (group I) and eight patients with complete rupture of the LHBT treated using an ADP (group II) since 2011. Preoperative Goutallier's fatty degeneration, range of motion (ROM), visual analogue scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, and Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score were assessed and healing failure was evaluated at 1 year after surgery by ultrasonography or magnetic resonance imaging.ResultsThe mean fatty degeneration in groups I and II was 3.9 and 3.6 for the supraspinatus (p = 0.288), 2.7 and 2.9 for the infraspinatus (p = 0.685), 0.9 and 1.3 for the subscapularis (p = 0.314), and 1.3 and 3.0 for the teres minor (p = 0.005), respectively. Subscapularis tears were found in 8 patients (33.3%) in group I and in 7 patients (87.5%) in group II (p = 0.023). Mean ROMs and functional scores improved significantly in group I (forward flexion: 121.7° to 153.3°, p = 0.010; external rotation: 32.7° to 52.7°, p = 0.001; external rotation at 90°: 63.3° to 74.5°, p = 0.031; internal rotation: T10.5 to T9.3, p = 0.045; VAS: 7.0 to 1.1, p < 0.001; ASES score: 45.4 to 81.6, p = 0.028; and Quick DASH score: 50.0 to 14.2, p = 0.017), whereas only VAS showed significant improvement in group II (from 5.9 to 2.0, p = 0.025) and ROMs and other functional scores increased without statistical significance in the group. Healing failure was found in 13 patients (54.2%) in group I and in 6 patients (75.0%) in group II (p = 0.404).ConclusionsThe surgeon should prudently choose surgical options for irreparable massive rotator cuff tears, especially in patients with severe fatty degeneration in the teres minor or combined biceps and subscapularis tears.

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“…Additionally, they initiate the regenerative responses following injury or degeneration. However, after the arthroscopic repair of rotator cuff, the re-tear rate has reported to be 25% to 91% [ 30 ]. That revealed the tendon-to-bone interface is unsuccessfully reintegrated.…”

Section: Resultsmentioning

confidence: 99%

Investigation of Growth Factor and Tenocyte Proliferation Induced by Platelet Rich Plasma (PRP) in a 3-Chamber Co-Culture Device

et al. 2018

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The platelet-rich plasma (PRP) has become an attractive topic for soft tissue healing therapy recently. While some clinical reports revealed the effective treatments for knee osteoarthritis, lateral epicondylitis, and rotator cuff tears, other case studies showed that there was no statistically significant healing improvement. The efficacy of the PRP therapy is still unclear clinically. Thus, a significant amount of basic studies should be conducted to optimize the preparation procedure and the platelet concentration of the PRP. In this work, a 3-chamber co-culture device was developed for the PRP study in order to reduce the usage of primary cells and to avoid the PRP gelation effect. The device was a culture, well partitioning into 3 sub-chambers. Tenocytes and PRP could be respectively loaded into the sub-chambers and co-cultured under the interlinked medium. The results showed that a higher platelet number in the PRP could diffuse higher concentration of the growth factors in the medium and induce higher tenocyte proliferation. The 3-chamber co-culture device provides a simple and practical tool for the PRP study. It is potentially applied for optimizing the preparation procedure and platelet concentration of the PRP therapy.

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Combined Subscapularis Tears in Massive Posterosuperior Rotator Cuff Tears

Cited by 39 publications

References 56 publications

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

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

Bridging Graft in Irreparable Massive Rotator Cuff Tears: Autogenic Biceps Graft versus Allogenic Dermal Patch Graft

Investigation of Growth Factor and Tenocyte Proliferation Induced by Platelet Rich Plasma (PRP) in a 3-Chamber Co-Culture Device

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