Alexandre Caubère1, Damien Lami2, Pascal Boileau3, Sébastien Parratte2, Matthieu Ollivier2, Jean-Noël Argenson2. 1. Department of Orthopaedic surgery, L'Assistance Publique Hôpitaux de Marseille, Institute for Locomotion, Sainte-Marguerite Hospital, Marseille, France. Electronic address: alexandre.caubere@hotmail.fr. 2. Department of Orthopaedic surgery, L'Assistance Publique Hôpitaux de Marseille, Institute for Locomotion, Sainte-Marguerite Hospital, Marseille, France. 3. Department of Orthopaedic Surgery and Sports Traumatology, Centre Hospitalier Universitaire Pasteur II, Medical University of Nice-Sophia-Antipolis, Nice, France.
Abstract
BACKGROUND: The Latarjet procedure is considered to be a violation of the subscapularis muscle. This study evaluated the postoperative status of the subscapularis through isokinetic and magnetic resonance imaging analysis after splitting. We hypothesized that compared with a healthy contralateral shoulder, there would be satisfactory recovery of subscapularis strength at the cost of some fatigability and some mild fatty infiltration. MATERIALS AND METHODS: This was a case-control retrospective study of patients who underwent a Latarjet procedure between January 2013 and January 2015. A total of 20 patients were reviewed at 1 year postoperatively. With the patient seated, strength testing of both shoulders was done (concentric, eccentric, and fatigability) with a dynamometer. Trophicity and fatty infiltration were analyzed by magnetic resonance imaging. RESULTS: Strength of the internal rotators (IRs) and external rotators (ERs) of the injured shoulder was significantly lower compared with the healthy shoulder in concentric testing at 180°/s and 60°/s (13% for IR and 20% for E, P < .05) and in eccentric testing at 60°/s (19% for IR and 16% for ER, P < .05). A peak torque ratio (ER/IR) of the operated-on shoulder was maintained. The difference in muscular endurance was significant (P < .001). There was no muscle atrophy and minimal or no fatty infiltration of the subscapularis in any patient. CONCLUSION: At 1 year after the open Latarjet procedure, isokinetic testing showed a combined strength deficit in both internal and external rotation with a conserved muscle balance. Although no significant subscapularis fatty infiltration or atrophy was noted, there was a significant deficit in endurance compared with the healthy shoulder.
BACKGROUND: The Latarjet procedure is considered to be a violation of the subscapularis muscle. This study evaluated the postoperative status of the subscapularis through isokinetic and magnetic resonance imaging analysis after splitting. We hypothesized that compared with a healthy contralateral shoulder, there would be satisfactory recovery of subscapularis strength at the cost of some fatigability and some mild fatty infiltration. MATERIALS AND METHODS: This was a case-control retrospective study of patients who underwent a Latarjet procedure between January 2013 and January 2015. A total of 20 patients were reviewed at 1 year postoperatively. With the patient seated, strength testing of both shoulders was done (concentric, eccentric, and fatigability) with a dynamometer. Trophicity and fatty infiltration were analyzed by magnetic resonance imaging. RESULTS: Strength of the internal rotators (IRs) and external rotators (ERs) of the injured shoulder was significantly lower compared with the healthy shoulder in concentric testing at 180°/s and 60°/s (13% for IR and 20% for E, P < .05) and in eccentric testing at 60°/s (19% for IR and 16% for ER, P < .05). A peak torque ratio (ER/IR) of the operated-on shoulder was maintained. The difference in muscular endurance was significant (P < .001). There was no muscle atrophy and minimal or no fatty infiltration of the subscapularis in any patient. CONCLUSION: At 1 year after the open Latarjet procedure, isokinetic testing showed a combined strength deficit in both internal and external rotation with a conserved muscle balance. Although no significant subscapularis fatty infiltration or atrophy was noted, there was a significant deficit in endurance compared with the healthy shoulder.
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