Subscapularis tendon tears

Abstract

Tears of the subscapularis tendon have been under-recognised until recently. Therefore, a high index of suspicion is essential for diagnosis.A directed physical examination, including the lift-off, belly-press and increased passive external rotation can help identify tears of the subscapularis.All planes on MR imaging should be carefully evaluated to identify tears of the subscapularis, retraction, atrophy and biceps pathology.Due to the tendency of the tendon to retract medially, acute and traumatic full-thickness tears should be repaired. Chronic tears without significant degeneration should be considered for repair if no contraindication exists.Arthroscopic repair can be performed using a 30-degree arthroscope and a laterally-based single row repair; one anchor for full thickness tears ⩽ 50% of tendon length and two anchors for those ⩾ 50% of tendon length.Biceps pathology, which is invariably present, should be addressed by tenotomy or tenodesis.Timing of post-operative rehabilitation is dictated by the size of the repair and the security of the repair construct. The stages of rehabilitation typically involve a period of immobilisation followed by range of movement exercises, with a delay in active internal rotation (IR) and strengthening in IR.Cite this article: EFORT Open Rev 2017;2:484–495. DOI: 10.1302/2058-5241.2.170015

A very rare case of an accessory subscapularis muscle and its potential clinical significance

“…They are usually associated with glenohumeral dislocation or large multi-tendon tears of the rotator cuff. Pain located in the anterior shoulder is characteristic of subscapularis tendon tears [ 13 ].…”

Single-Portal, Single-Anchor Repair of a Superior Third Subscapularis Tear Using a Self-Punching Knotless Soft Suture Anchor

“… 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 Through the advancements of arthroscopic techniques, numerous investigators have proposed various techniques of varying complexity for repair of isolated subscapularis tears. 18 , 26 , 27 , 28 , 29 , 30 , 31 , 32 Van der Zwaal et al. proposed that an additional anchor should be placed for every 1 cm of the subscapularis involved in the tear.…”

“… 15 , 25 Since the advent and advancement of arthroscopic techniques, many techniques have recently evolved for arthroscopic subscapularis repair. 18 , 26 , 27 , 28 , 29 , 30 , 31 , 32 To our knowledge, in regard to arthroscopic repair of Lafosse type II/superior third subscapularis tears, there exists no published literature highlighting the efficacy of using a single, knotless soft suture anchor solely through an anterior working portal. The purpose of this Technical Note and video ( Video 1 ) is to present an arthroscopic repair of a full-thickness superior third subscapularis tear using a knotless, soft anchor through a single anterior portal.…”

Floating Subscapularis Tear: A Variation of the Partial Subscapularis Tear

“…The prevalence of subscapularis tendon tears had been largely underestimated before arthroscopic examination became popular in the 2000s. Currently, the diagnosis of full-thickness subscapularis tear is routinely made arthroscopically and with reliable accuracy, with reporting tear-rate up to 29% [ 4 , 5 , 6 ]. In most cases of a full-thickness subscapular tear, the torn tendon retracts medially and inferiorly; however, as the superior glenohumeral ligament and coracohumeral ligament are attached to the subscapularis, it assumes a comma shape (so-called “comma sign”), which is thought to be pathognomonic of a subscapularis tear ( Figure 1 ) [ 7 ].…”