Efficiency Release of Supraspinatus Nerve During Arthroscopic Repair in Posttraumatic Rupture of the Supraspinal Muscle Tendon

Abstract

Supraspinatus injuries may be associated with traction injury to the suprascapular nerve, potentially responsible for rotator cuff pain or weakness and as a consequence have an impact on early recovery from tendon suture. Purpose: to study the results of release of the suprascapular nerve in the superior notch of the scapula during arthroscopic repair surgery of the supraspinatus tendon of the shoulder joint depending of the extent of damage. Materials and methods: The study included 121 patients. The patients were divided into 2 groups. Group A consisted of patients who underwent arthroscopic repair of the supraspinatus tendon. Group B included patients who underwent the same operation with additional release of the suprascapular nerve in the superior notch of the scapula. An assessment was made before surgery using the DASH (Disabilities of the Arm, Shoulder and Hand) and VAS (visual analogue scale) scales, and then at 1, 6, 12 months after surgery and the degree of dystrophy according to the Goutallier classification in T1-weighted MRI before surgery, and then 3, 6, 12 months after surgery. Results: The difference between the groups according to Goutalier classification in the third month after surgery was 0.04, according to the VAS assessment in the first month after surgery was p < 0.01, and at the same period a statistically significant difference was found in the DASH assessment (p = 0.01). Discussion: There are conflicting results regarding the issue being studied. This is explained by the lack of knowledge of pathophysiological processes in this area, as well as the high level of evidence of published studies. Conclusion: Additional release of the supraspinatus nerve in the scapular notch during repair of the supraspinatus muscle is effective in the early stages of recovery, and is also of greatest importance in cases of massive tears.