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Arthroscopic repair of a significant (>50%) partial-thickness subscapularis tear concomitant with a full-thickness supraspinatus tear: technical considerations for subscapularis repair (transtendon technique versus tear completion)

Authors
 Sung Jae Kim  ;  Min Jung  ;  Jae Hoo Lee  ;  Jae Han Park  ;  Yong Min Chun 
Citation
 JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol.24(6) : 875-881, 2015 
Journal Title
JOURNAL OF SHOULDER AND ELBOW SURGERY
ISSN
 1058-2746 
Issue Date
2015
MeSH
Aged ; Arthrography ; Arthroscopy/methods* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Rotation ; Rotator Cuff/surgery* ; Rotator Cuff Injuries ; Rupture/surgery ; Shoulder Joint/diagnostic imaging ; Shoulder Joint/physiopathology* ; Shoulder Joint/surgery* ; Tendon Injuries/surgery* ; Tomography, X-Ray ; Treatment Outcome
Keywords
Shoulder ; arthroscopy ; repair ; rotator cuff tear ; subscapularis
Abstract
BACKGROUND: The purpose of this study was to compare clinical outcomes and structural integrity of arthroscopic repair by either transtendon repair or tear completion for a significant (>50%) partial-thickness articular-side subscapularis tear associated with a full-thickness supraspinatus tear.
METHODS: The study population comprised 109 patients who underwent arthroscopic repair for partial-thickness subscapularis tears associated with full-thickness supraspinatus tears with either a transtendon technique (81 patients, group T) or tear completion (28 patients, group C). Pain on a visual analog scale; the Subjective Shoulder Value; the American Shoulder and Elbow Surgeons score; and the University of California, Los Angeles shoulder score were used to compare clinical outcomes between the 2 groups. At 6 months after surgery, magnetic resonance arthrography or computed tomographic arthrography was performed to assess structural integrity.
RESULTS: At the 2-year follow-up, there were no significant differences in functional outcomes between groups. In group T, external rotation was reduced significantly from 55° to 51° (P < .001). The subscapularis and overall retear rates were 8% and 19%, respectively, in group T and 12% and 23%, respectively, in group C. There were no significant differences in retear rates between groups.
CONCLUSIONS: Arthroscopic repair of partial-thickness subscapularis tears associated with full-thickness supraspinatus tears using either the transtendon technique or tear completion resulted in significant functional improvements in both groups except for postoperative external rotation in group T, and there were no significant differences between groups. The retear rates were also not significantly different between groups. However, after subscapularis repair using the transtendon technique, some patients may have decreased external rotation.
Full Text
http://www.sciencedirect.com/science/article/pii/S1058274614005758
DOI
10.1016/j.jse.2014.10.009
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jae Han(박재한) ORCID logo https://orcid.org/0000-0001-6801-612X
Jung, Min(정민) ORCID logo https://orcid.org/0000-0002-7527-4802
Chun, Yong Min(천용민) ORCID logo https://orcid.org/0000-0002-8147-6136
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140208
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