HYPOTHESIS: We studied the results of tendon-to-tendon repair of the subscapularis during total shoulder arthroplasty (TSA) to compare its clinical results relative to more recent studies looking at osteotomy of the lesser tuberosity. MATERIALS AND METHODS: This study analyzed the postoperative integrity of the subscapularis by a tendon-to-tendon repair in 45 arthroplasties in 43 patients. RESULTS: Preoperatively, 23 patients had a negative lift-off test; 22 could not perform the test. Postoperatively, 41 patients had a negative lift-off test; four could not reach behind themselves to do the test. All 45 shoulders had a negative belly-press test pre-operatively and post-operatively. DISCUSSION: Tendon-to-tendon repair is simpler, quicker, and avoids the possibility of an osteotomy nonunion. Tendon-to-tendon repair of the subscapularis tenotomy in shoulder arthroplasty remains an option in the presence of reasonable quality tendon, utilizing relaxing sutures (partial closure of the lateral rotator interval), and limiting early postoperative passive external rotation. LEVEL OF EVIDENCE: Level 4; Retrospective case series, no control group.
HYPOTHESIS: We studied the results of tendon-to-tendon repair of the subscapularis during total shoulder arthroplasty (TSA) to compare its clinical results relative to more recent studies looking at osteotomy of the lesser tuberosity. MATERIALS AND METHODS: This study analyzed the postoperative integrity of the subscapularis by a tendon-to-tendon repair in 45 arthroplasties in 43 patients. RESULTS: Preoperatively, 23 patients had a negative lift-off test; 22 could not perform the test. Postoperatively, 41 patients had a negative lift-off test; four could not reach behind themselves to do the test. All 45 shoulders had a negative belly-press test pre-operatively and post-operatively. DISCUSSION: Tendon-to-tendon repair is simpler, quicker, and avoids the possibility of an osteotomy nonunion. Tendon-to-tendon repair of the subscapularis tenotomy in shoulder arthroplasty remains an option in the presence of reasonable quality tendon, utilizing relaxing sutures (partial closure of the lateral rotator interval), and limiting early postoperative passive external rotation. LEVEL OF EVIDENCE: Level 4; Retrospective case series, no control group.
Authors: June S Kennedy; Grant E Garrigues; Federico Pozzi; Matthew J Zens; Bryce Gaunt; Brian Phillips; Ashim Bakshi; Angela R Tate Journal: J Shoulder Elbow Surg Date: 2020-06-10 Impact factor: 3.019