Do coracohumeral interval and glenoid version play a role in subscapularis tears?

Sundararajan, Silvampatti Ramasamy; Joseph, Joseph Babu; Ramakanth, Rajagopalakrishnan; Jha, Amit Chandra; Rajasekaran, Shanmuganathan

doi:10.1016/j.jseint.2020.07.006

Cited by 4 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…That is, the decreased coracohumeral interval is a result of rotator cuff dysfunction and anterior translation of the humeral head, rather than the primary anatomical characteristic, similar to the notion in subacromial impingement [12]. This concept may also explain, at least partly, why diverse results exist regarding the relationship between coracoid morphology and SSC tears [19, 25, 28]. Together, these results suggest that coracoplasty increases surgical invasiveness, exacerbates postoperative pain and brings no obvious benefit.…”

Section: Discussionmentioning

confidence: 99%

Bilateral coracohumeral distance discrepancy is associated with subscapularis tear in rotator cuff rupture patients

Zhu

Tan

et al. 2021

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose To describe the bilateral coracohumeral morphological discrepancy in rotator cuf rupture patients with and without subscapularis (SSC) involvement and to investigate its association with SSC tears. Methods Two hundred and thirteen consecutive patients who were scheduled to have arthroscopic rotator cuf repair were prospectively enrolled in the current study. Patients with acute traumatic rotator cuf rupture, glenohumeral osteoarthritis, bilateral rotator cuf rupture, recurrent shoulder instability, systemic inlammatory disease, and previous shoulder surgery history were excluded. Coracohumeral distance (CHD), coracoid overlap (CO), lesser tuberosity index (LTI) and acromiohumeral interval (AHI) were measured bilaterally using CT scans. Based on arthroscopic indings, patients were included in either the SSC tear group (n = 72) or the control group (n = 141). ResultsIn the SSC tear group, the afected shoulder possessed a signiicantly smaller CHD [95% conidence interval (CI) 6.1-7.2 vs. 7.2-8.0 mm, p < 0.0001], larger LTI (95% CI 9.4-9.9 vs. 9.0-9.6 mm, p < 0.0001), and smaller AHI (95% CI 5.0-5.5 vs. 7.1-7.5 mm, p < 0.0001) than the contralateral normal shoulder. In the control group, there was no signiicant diference between bilateral CHD and CO, and the AHI bilateral discrepancy was less distinct. CO did not difer signiicantly in the bilateral comparison in either group. Among all evaluated parameters, bilateral CHD discrepancy was the best predictor of SSC tears, with an area under the curve (AUC) of 0.882. A cutof value of 0.5 mm had a sensitivity of 76.4% and speciicity of 99.3% for SSC tears. ConclusionThe CHD values are signiicantly diferent between afected and contralateral shoulders in SSC tear patients. Bilateral CHD discrepancy is closely associated with subcoracoid impingement and SSC tears, and its presence warrants speciic intraoperative SSC inspection. Level of evidence Level II.

show abstract

Section: Discussionmentioning

confidence: 99%

Bilateral coracohumeral distance discrepancy is associated with subscapularis tear in rotator cuff rupture patients

Zhu

Tan

et al. 2021

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Finally, the reason leading to an inSSC tear remains unclear [40, 41]. Since most of SSC lesions are partial tears at the upper third of articular side, the reasons of intratendinous tears may be different from those articular side tears [42]. Instability of the LHBT might be one of the reasons, but it is unclear whether it is the instability of the LHBT causes the inSSC tear or the inSSC tear results in the LHBT instability.…”

Section: Discussionmentioning

confidence: 99%

The prevalence, classification, radiological and arthroscopic findings of intratendinous subscapularis tears

Lin

Zhang

Cui

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PurposeTo investigate the clinical characteristics of intratendinous subscapularis (inSSC) tears. MethodsRetrospectively, 69 patients with arthroscopically confirmed inSSC tears were identified from 2018 to 2019. Preoperatively and at final follow‐up, thorough physical examination was performed and clinical outcomes (American Shoulder and Elbow Surgeons [ASES] score; University of California, Los Angeles [UCLA] score; visual analogue scale [VAS] for pain; and Simple Shoulder Test [SST]) were recorded. Features of pre‐operative magnetic resonance image (MRI) such as high signalling within the tendon substance, communication to the bicipital groove and long head of biceps tendon (LHBT) lesions were investigated. Characteristics of arthroscopic view were investigated. Bear‐hug and internal rotation resistance test at 90° abduction and external rotation (IRRT90°) test were used to assess the SSC strength. ResultsThe mean follow‐up was 2.4 (2–3) years. The prevalence of arthroscopically confirmed inSSC tears was 69/675 (10.2%) among arthroscopic rotator cuff repairs. Pre‐operative physical examination found positive IRRT90° and bear‐hug test in 41/60 (68.3%) and 42/69 (60.8%) patients, respectively. The Cohen kappa coefficient was interpreted to be substantial for the evaluation of all MRI parameters. According to the conditions of LHBT, inSSC tears were classified into 3 types: type I: without LHBT subluxation and tear; type II: with LHBT subluxation or tears and type III: with LHBT dislocation. At final follow‐up, mean ASES, UCLA, VAS, and SST scores improved significantly from mean of 50.6 ± 14.7, 19.4 ± 3.07, 6.2 ± 2.0, and 6.1 ± 2.5 to mean of 90.7 ± 9.5, 32.2 ± 1.8, 1.4 ± 1.2 and 9.8 ± 2.2, respectively (P < 0.001). Bilateral symmetric strength was found by bear‐hug and IRRT90° test in all patients postoperatively. ConclusionUnderstanding features of pre‐operative MRI, physical examination and arthroscopic view is helpful to identify inSSC tears. Arthroscopic repair yielded satisfactory clinical outcomes in patients with inSSC tears. Level of evidenceLevel IV.

show abstract

“…7). Arthroscopic PCL avulsion fixation is more time-consuming with a larger cost burden compared to open approaches (49), but in the case of other concomitant intra-articular injuries, it may lead to a better chance of a return to pre-injury activities (42).…”

Section: Pcl Avulsion Fracturementioning

confidence: 99%

Is posterior knee arthroscopy using posterior portals necessary for orthopedic surgeons? The latest evidence on applications and techniques

et al. 2023

View full text Add to dashboard Cite

Various uses of posterior knee arthroscopy have been shown, including all-inside repair of posterior meniscal lesions, posterior cruciate ligament (PCL) reconstruction or PCL avulsion fixation, extensile posterior knee synovectomy for pigmented villonodular synovitis or synovial chondromatosis, posterior capsular release in the setting of knee flexion contractures, and loose bodies removal. Posterior arthroscopy provides direct access to the posterior meniscal borders for adequate abrasion and fibrous tissue removal. This direct view of the knee posterior structures enables the surgeon to create a stronger biomechanical repair using vertical mattress sutures. During PCL reconstruction, posterior arthroscopy gives the surgeon proper double access to the tibial insertion site, which can result in less acute curve angles and the creation of a more anatomic tibial tunnel. Moreover, it gives the best opportunity to preserve the PCL remnant. Arthroscopic PCL avulsion fixation is more time-consuming with a larger cost burden compared to open approaches, but in the case of other concomitant intra-articular injuries, it may lead to a better chance of a return to pre-injury activities. The high learning curve and overcaution of neuromuscular injury have discouraged surgeons from practicing posterior knee arthroscopy using posterior portals. Evidence for using posterior portals by experienced surgeons suggests fewer complications. The evidence suggests toward learning posterior knee arthroscopy, and this technique must be part of the education about arthroscopy. In today's professional sports world, where the quick and complete return of athletes to their professional activities is irreplaceable, the use of posterior knee arthroscopy is necessary.

show abstract

Do coracohumeral interval and glenoid version play a role in subscapularis tears?

Cited by 4 publications

References 29 publications

Bilateral coracohumeral distance discrepancy is associated with subscapularis tear in rotator cuff rupture patients

Bilateral coracohumeral distance discrepancy is associated with subscapularis tear in rotator cuff rupture patients

The prevalence, classification, radiological and arthroscopic findings of intratendinous subscapularis tears

Is posterior knee arthroscopy using posterior portals necessary for orthopedic surgeons? The latest evidence on applications and techniques

Contact Info

Product

Resources

About