4.5 Article

Arthroscopic Repair of Isolated Partial- and Full-Thickness Upper Third Subscapularis Tendon Tears: Minimum 2-Year Outcomes After Single-Anchor Repair and Biceps Tenodesis

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Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.arthro.2017.01.027

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Funding

  1. Arthrex
  2. Smith Nephew
  3. Siemens
  4. Ossur
  5. Vail Valley Medical Center

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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.

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