Arthroscopic repair of isolated Subscapularis tears

Authors: L. Lafosse, Y. Reiland, G. Baier, S. Audebert, B. Jost

References: SECEC 2005

Abstract
AIMS: Whereas open Subscapularis repair is reported to be successful, the outcome of all arthroscopic Subscapularis repair is not yet known. The purpose of this study is to evaluate the results of arthroscopic repair of the isolated Subscapularis tear.

MATERIALS: Arthroscopic repairs of isolated transmural Subscapularis tears were performed in 17 consecutive patients. The 13 males and 4 females had an average age of 47 years. The dominant side was involved in 94%. Tears of the Subscapularis were diagnosed clinically (lift off and belly press-test) and the Arthro-CT scan. Subscapularis repair was performed all arthroscopic withy suture anchors and non-absorbable sutures. The prospective study evaluated the patients by pre- and postoperative with clinical (Constant Score and UCLA score) and with pre and postoperative Arthro-CT scan.

RESULTS: After a mean follow-up of 24 months the average relative Constant score significantly increased from 58% preoperatively to 96% postoperatively (p<0.05) as well as the UCLA score from 16 to 32 points (p<0.05). Pain improved from 5.9 points to 13.5 points (p<0.05), forward flexion from 146 to 175 (p<0.05), external rotation from 50 to 61 (p<0.05), internal rotation from sacrum to L12 (p<0.05) and abduction strength from 7.4 to 15.6 points (p<0.05). Two patients had a partial rerupture of the Subscapularis tendon. Radiologically there was not progression of the fatty muscle infiltration.

CONCLUSION: All arthroscopic repairs of isolated transmural Subscapularis tears yield good results with restoration of shoulder function at least similar to open repair.