J Christoph Katthagen1, Alexander R Vap2, Dimitri S Tahal3, Marilee P Horan3, Peter J Millett4. 1. Center for Outcomes-Based Orthopaedic Research at the Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany. 2. Center for Outcomes-Based Orthopaedic Research at the Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A. 3. Center for Outcomes-Based Orthopaedic Research at the Steadman Philippon Research Institute, Vail, Colorado, U.S.A. 4. Center for Outcomes-Based Orthopaedic Research at the Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.. Electronic address: drmillett@thesteadmanclinic.com.
Abstract
PURPOSE: To investigate outcomes of arthroscopic single-anchor repair and biceps tenodesis of partial- and full-thickness tears of the upper third subscapularis (SSC). METHODS: Thirty-three patients with arthroscopically confirmed isolated SSC tears, Lafosse type I (>50% of the tendon thickness involved), or type II were included. All patients underwent arthroscopic subcoracoid decompression, coracoplasty if the coracohumeral distance was narrowed, biceps tenodesis, and a single-anchor repair of the upper third SSC. No other reconstructive procedures were performed. Subjective evaluations included American Shoulder and Elbow Surgeons, Short-Form 12, Quick Disabilities of the Arm, Shoulder and Hand, Single Assessment Numeric Evaluation, and visual analog scale pain scores preoperatively and at minimum 2 years postoperatively. RESULTS: Thirty-one patients (n = 25 male, n = 6 female) were included in the final collective, because 2 patients refused participation. Minimum 2-year follow-up data were available for 28 of the 31 patients (90.3%). The mean age at the time of surgery was 54.8 (range, 36-71) years. The mean follow-up was 4.1 (range, 2.0-8.0) years. The results of all outcome measures improved significantly postoperatively compared with preoperative scores (P < .05). Patients with single-anchor repair of type II SSC tears (n = 17) had a significantly higher mean postoperative American Shoulder and Elbow Surgeons score (93.7 ± 10.8) than patients with single-anchor repair of type I SSC tears (n = 11; 86.7 ± 10.9; P = .027). CONCLUSIONS: Arthroscopic single-anchor repair of upper third SSC tendon tears led to improved function and decreased pain with high patient satisfaction. Outcomes of full-thickness upper third SSC tears were more favorable compared with outcomes of high grade partial-thickness upper third SSC tears. LEVEL OF EVIDENCE: Level IV, retrospective therapeutic case series.
PURPOSE: To investigate outcomes of arthroscopic single-anchor repair and biceps tenodesis of partial- and full-thickness tears of the upper third subscapularis (SSC). METHODS: Thirty-three patients with arthroscopically confirmed isolated SSC tears, Lafosse type I (>50% of the tendon thickness involved), or type II were included. All patients underwent arthroscopic subcoracoid decompression, coracoplasty if the coracohumeral distance was narrowed, biceps tenodesis, and a single-anchor repair of the upper third SSC. No other reconstructive procedures were performed. Subjective evaluations included American Shoulder and Elbow Surgeons, Short-Form 12, Quick Disabilities of the Arm, Shoulder and Hand, Single Assessment Numeric Evaluation, and visual analog scale pain scores preoperatively and at minimum 2 years postoperatively. RESULTS: Thirty-one patients (n = 25 male, n = 6 female) were included in the final collective, because 2 patients refused participation. Minimum 2-year follow-up data were available for 28 of the 31 patients (90.3%). The mean age at the time of surgery was 54.8 (range, 36-71) years. The mean follow-up was 4.1 (range, 2.0-8.0) years. The results of all outcome measures improved significantly postoperatively compared with preoperative scores (P < .05). Patients with single-anchor repair of type II SSC tears (n = 17) had a significantly higher mean postoperative American Shoulder and Elbow Surgeons score (93.7 ± 10.8) than patients with single-anchor repair of type I SSC tears (n = 11; 86.7 ± 10.9; P = .027). CONCLUSIONS: Arthroscopic single-anchor repair of upper third SSC tendon tears led to improved function and decreased pain with high patient satisfaction. Outcomes of full-thickness upper third SSC tears were more favorable compared with outcomes of high grade partial-thickness upper third SSC tears. LEVEL OF EVIDENCE: Level IV, retrospective therapeutic case series.
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