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Abstract
Purpose
Subscapularis tendon tears associated with supraspinatus tendon tears are often found during rotator cuff repair. However, there have been only a few reports about both subscapularis and rotator cuff repair. The authors conducted arthroscopic repair for cuff tear associated with subscapularis tendon tear and assessed its outcomes.
Materials and Methods
We evaluated 320 cases of arthroscopic repair following rotator cuff tear between June 2006 and January 2009 at Gil Medical Center. Out of 66 cases (21%) associated with subscapularis tear, forty cases of bone to tendon repair using suture anchor were selected except for 26 cases of tendon to tendon repair. Clinical outcomes of 25 cases followed up for over a year were finally assessed. Clinical outcomes were evaluated using the following measures: range of shoulder motion, muscle strength, belly press test, Visual Analogue Scale (VAS) on pain, and University of California Los Angeles (UCLA) score.
Results
The average VAS pain scale improved from 5.3 preoperatively to 1.4 postoperatively. Internal rotation strength increased from its preoperative level, 4.1 to 4.2 in postoperative 6 months and to 4.6 at last follow-up. Range of internal rotation increased from the second lumbar level at postoperative 6 months to the 11th thoracic level at last follow-up. UCLA score had significantly improved from 17.4 to 30.8 (p<0.05).
Figures and Tables
Figure 1
Repair of subscapularis tendon. (A) Arthroscopic photograph from a posterior viewing portal shows tear of upper portion of subscapularis tendon. (B) The torn end was held with grasper to evaluate tension around the repair. (C) A corkscrew suture anchor was inserted through the anterior portal at insertional area of subscapularis tendon. (D) After knot tying, upper border of subscapuaris tendon was reconstructed.
Figure 2
Repair of subscapularis using two anterior portals. (A) The completely torn and retracted subscapularis tendon (arrow). (B) The capsular attachment of torn subscapularis tendon was released through the anterolateral portal. (C) A metallic suture anchor was inserted through the anteromedial portal. (D) The subscapularis tendon was repaired without excessive tension.
Figure 3
Concomitant lesions of long head of biceps tendon. (A) Partial tear of biceps tendon. (B) Partial tear of biceps tendon in the intertubercular groove including tear of the supraspinatus tendon (arrow). (C) Biceps tendon was dislocated medially with disrupted pulley integrity and tear of upper subscapularis tendon (arrow).
References
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