Yong Girl Rhee1, Yeong Seok Lee2, Yong Bok Park3, Jung Youn Kim4, Kwang Joon Han2, Jae Chul Yoo5. 1. Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea. 2. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 3. Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, Soonchunhyang University School of Medicine, Bucheon, Republic of Korea. 4. Department Of Orthopaedic Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea. 5. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: shoulderyoo@gmail.com.
Abstract
BACKGROUND: This study evaluated clinical outcomes for isolated subscapularis tendon tears treated by arthroscopic repair, the factors affecting clinical outcomes, and changes in tendon structural integrity using magnetic resonance imaging. METHODS: Between 2005 and 2013, 45 patients with isolated subscapularis tendon tears were enrolled from two institutions. Clinical outcomes were assessed using the pain visual analog scale, American Shoulder and Elbow Surgeons, and Simple Shoulder Test scores. We evaluated factors affecting clinical outcomes: trauma history, tear classification, sex, age, symptom duration, preoperative fatty infiltration grade, cross-sectional area (CSA), cranial-transversal diameter, and caudal-transversal diameter. Subscapularis tendon integrity and fatty infiltration grade were evaluated using magnetic resonance imaging. RESULTS: No complications occurred except for tendon rerupture in 1 patient. No significant changes in tendon structural integrity occurred except for those related to CSA. Tendon structural integrity was significantly different between tears less than one-fourth of the entire subscapularis tendon and those exceeding one-fourth. However, there were no statistically significant differences in clinical outcomes between the 2 types of tear. Age was significantly associated with clinical outcomes, including Constant, American Shoulder and Elbow Surgeons, and Simple Shoulder Test scores. Men experienced better outcomes than women in Constant and Simple Shoulder Test scores. As the postoperative period progressed, the difference in CSA, cranial-transversal diameter, and caudal-transversal diameter decreased to the point of no statistical significance. CONCLUSION: Arthroscopic repair of isolated subscapularis tear provided significant functional improvements with a low rerupture rate. Age was significantly associated with clinical results.
BACKGROUND: This study evaluated clinical outcomes for isolated subscapularis tendon tears treated by arthroscopic repair, the factors affecting clinical outcomes, and changes in tendon structural integrity using magnetic resonance imaging. METHODS: Between 2005 and 2013, 45 patients with isolated subscapularis tendon tears were enrolled from two institutions. Clinical outcomes were assessed using the pain visual analog scale, American Shoulder and Elbow Surgeons, and Simple Shoulder Test scores. We evaluated factors affecting clinical outcomes: trauma history, tear classification, sex, age, symptom duration, preoperative fatty infiltration grade, cross-sectional area (CSA), cranial-transversal diameter, and caudal-transversal diameter. Subscapularis tendon integrity and fatty infiltration grade were evaluated using magnetic resonance imaging. RESULTS: No complications occurred except for tendon rerupture in 1 patient. No significant changes in tendon structural integrity occurred except for those related to CSA. Tendon structural integrity was significantly different between tears less than one-fourth of the entire subscapularis tendon and those exceeding one-fourth. However, there were no statistically significant differences in clinical outcomes between the 2 types of tear. Age was significantly associated with clinical outcomes, including Constant, American Shoulder and Elbow Surgeons, and Simple Shoulder Test scores. Men experienced better outcomes than women in Constant and Simple Shoulder Test scores. As the postoperative period progressed, the difference in CSA, cranial-transversal diameter, and caudal-transversal diameter decreased to the point of no statistical significance. CONCLUSION: Arthroscopic repair of isolated subscapularis tear provided significant functional improvements with a low rerupture rate. Age was significantly associated with clinical results.
Authors: Augusto Cigolotti; Carlo Biz; Erik Lerjefors; Gianfranco de Iudicibus; Elisa Belluzzi; Pietro Ruggieri Journal: Arch Med Sci Date: 2020-07-28 Impact factor: 3.318