The outcomes and affecting factors after arthroscopic isolated subscapularis tendon repair

Rhee, Yong Girl; Lee, Yeong Seok; Park, Yong Bok; Kim, Jung Youn; Han, Kwang Joon; Yoo, Jae Chul

doi:10.1016/j.jse.2017.05.017

Cited by 19 publications

(17 citation statements)

References 30 publications

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“…In another study, Lanz et al [9] had excellent outcomes for arthroscopic isolated subscapularis repair of 52 patients with a mean follow-up period of 35 months. In an evaluation of the patients who underwent arthroscopic repair for a clinically symptomatic isolated subscapularis tendon tear after a mean clinical follow-up of 49 months, Rhee et al [15] reported postoperative STT scores of 10.2 and 9.7, which were similar to the results of the control group of the current study.…”

Section: Discussionsupporting

confidence: 81%

“…[13] Most of them are degenerative tears due to intrinsic changes and subcoracoid impingement syndrome is a rare cause in etiology. [14,15] On the other hand, subcoracoid impingement syndrome is diagnosed clinically and radiologically. The cutoff value of CHD to support the diagnosis in clinically compatible patients in MRIs has not been clearly defined.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is routine coracoplasty necessary in isolated subscapularis tears?

Ayanoğlu

Ataoğlu

Özer

et al. 2019

Eklem Hastalik Cerrahisi

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Is routine coracoplasty necessary in isolated subscapularis tears?

Ayanoğlu

Ataoğlu

Özer

et al. 2019

Eklem Hastalik Cerrahisi

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“…52 Regarding postoperative physical management, all of the patients in the current study were immobilized for 4 to 6 weeks with restriction of passive ROM, similar to previous reports that focused on tears that involved the SSC. 1,50 However, authors of some previous studies allowed passive mobilization during the first 6 weeks while active movements were restricted. 3,15 Evidence is lacking regarding the optimum postoperative rehabilitation protocol after repairs of RCTs involving the SSC, a topic that requires further comparative studies in the future.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Functional and Radiological Outcomes of Tears Involving the Subscapularis: Isolated Subscapularis Versus Combined Anterosuperior Rotator Cuff Tears

Meshram

Rhee

Park

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Few studies have compared the clinical and radiological characteristics and outcomes in isolated subscapularis (SSC) and combined anterosuperior (AS) rotator cuff tears (RCTs). Furthermore, risk factors for retear after SSC repair and the effect of preoperative fatty degeneration require further evaluation.Purpose: To compare the functional and radiological outcomes of isolated SSC with combined AS RCTs after arthroscopic repair and to determine the risk factors for SSC retear in these 2 groups.Study Design: Cohort study; Level of evidence, 3.Methods: Data from 30 patients in the isolated SSC group were compared with data from 110 patients in the combined AS group. All patients underwent primary arthroscopic rotator cuff repair between 2010 and 2016. Clinical outcomes were assessed through use of the visual analog scale for pain, American Shoulder and Elbow Surgeons score, and Simple Shoulder Test at a mean followup of 26.7 months (range, 24-96 months). SSC tendon integrity was examined via magnetic resonance imaging, computed tomography arthrogram, or ultrasonography at least 1 year after surgery.Results: The isolated SSC group had a greater proportion of males and the patients were younger compared with the combined AS group (both P < .050). The incidence of trauma was high but not significantly different between groups (56.7% vs 40.9%; P ¼ .180). Clinical outcome measures and radiological outcomes in terms of retear were not statistically different between both groups (16.7% vs 8/5%; P ¼ .337). The optimal cutoff values for the risk of SSC tendon retear in both groups were 19-mm retraction and 16-mm superoinferior dimension (P ¼ .048). Unfavorable preoperative fatty degeneration of the SSC muscle (grades 3 and 4) was a significant risk factor for retear (odds ratio, 9.8; P < .001).Conclusion: Isolated SSC and combined AS RCTs were comparable except for patient age and sex; both had a high incidence of traumatic history. The current data suggest that the risk factors for retear after SSC repair in RCTs involving the SSC were tear size greater than 19 mm of retraction and unfavorable fatty degeneration (grade 3 or higher) of the SSC muscle.Recently, an increase has been noted in the number of studies focused on rotator cuff tears (RCTs) involving the subscapularis (SSC) muscle to enable a better understanding of the diagnosis, management, and outcomes. 35 The SSC is the largest rotator cuff tendon; it provides 50% of the rotator cuff force and plays an important role in shoulder stability and movements such as internal rotation, adduction, abduction, flexion, and extension. 13,20,25,43 Hence, restoring the function of the SSC muscle after a tear is crucial for normal shoulder function.The SSC muscle is reported to be involved in 78% of RCTs, most often in combination with other rotator cuff tendons. 40 The incidence of isolated SSC RCTs is reported to be 4%, 13 whereas combined RCTs involving the SSC and supraspinatus but without the infraspinatus (combined anterosuperior [AS]) are reported to accoun...

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“…Previous studies concerning RCTs have claimed that clinical improvement does not depend on different age categories [15,16,[53][54][55][56] despite the higher rate of rotator cuff re-tears and the lower rate of tendon healing at 6-month MRI follow-up found in the elderly [16,57]. To the best of our knowledge, only two studies have been published investigating the influence of age on the clinical outcomes of patients with STTs divided by injury type [11,58]. Adams et al did not find any correlation between age and clinical outcomes (UCLA, VAS and ASES scores) [11], while Rhee et al found a correlation with Constant, ASES, and Simple Shoulder Test scores [58].…”

Section: Discussionmentioning

confidence: 99%

Medium- to long-term clinical and functional outcomes of isolated and combined subscapularis tears repaired arthroscopically

et al. 2021

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Introduction: The purpose of this study was twofold. First, the efficacy of arthroscopic repair in patients with full thickness, isolated subscapularis tendon tears (I-STTs) or combined subscapularis tendon tears (C-STTs) involving the rotator cuff tendons was evaluated. Second, the outcomes between these two groups were compared. The influence of age and gender on the cohort clinical outcomes was also analysed. Our hypothesis was that satisfactory functional results could be obtained arthroscopically in both groups without any influence of age or gender. Material and methods: Seventy-nine patients were enrolled: 15 with I-STTs and 64 with C-STTs. The clinical outcomes were assessed using Constant and Disabilities of the Arm, Shoulder and Hand (DASH) scores, Numeric Rating Scale (NRS) for pain and Visual Analogue Scale (VAS) for satisfaction. The subscapularis strength was assessed using a comparative dynamometric bear-hug test. Group outcomes were compared, including statistical analysis. Results: For each group, there were no differences regarding the subscapularis strength of the operated and non-operated shoulders. A comparison of the post-with the pre-operative outcomes showed an increase in the Constant score and a decrease in the NRS. Comparing the two groups, we found no difference in strength of the operated and non-operated shoulders, but a significant difference in relation to pre-operative Constant score and pre-operative NRS. Age was negatively correlated with both pre-operative and post-operative Constant scores. No association was found between gender and the outcomes, although the DASH score was higher in women. Conclusions: Arthroscopic repair of STTs provided functional restoration, pain relief and patient satisfaction in both groups. Age and gender did not affect the clinical outcomes achieved by arthroscopic STT repair.

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The outcomes and affecting factors after arthroscopic isolated subscapularis tendon repair

Cited by 19 publications

References 30 publications

Is routine coracoplasty necessary in isolated subscapularis tears?

Is routine coracoplasty necessary in isolated subscapularis tears?

Comparison of Functional and Radiological Outcomes of Tears Involving the Subscapularis: Isolated Subscapularis Versus Combined Anterosuperior Rotator Cuff Tears

Medium- to long-term clinical and functional outcomes of isolated and combined subscapularis tears repaired arthroscopically

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