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Concomitant coracoplasty during arthroscopic subscapularis repair does not yield better clinical outcomes and structural integrity

 Sung-Jae Kim  ;  Yun-Rak Choi  ;  Min Jung  ;  Yeo-Kwon Yoon  ;  Yong-Min Chun 
 Knee Surgery Sports Traumatology Arthroscopy, Vol.26(1) : 56-62, 2018 
Journal Title
 Knee Surgery Sports Traumatology Arthroscopy 
Issue Date
Adult ; Aged ; Arthroscopy ; Coracoid Process/injuries/*surgery ; Female ; Humans ; Male ; Middle Aged ; Articular Range of Motion ; Rotator Cuff/*surgery ; Rotator Cuff Injuries/*surgery ; Rupture ; Shoulder Joint/surgery
Arthroscopy ; Coracoplasty ; Repair ; Subscapularis tear
PURPOSE: Few studies have examined whether concomitant coracoplasty is necessary to improve clinical and radiological outcomes after arthroscopic subscapularis repair. The purpose of this study was to compare clinical outcomes and structural integrity after arthroscopic repair of isolated subscapularis full-thickness tear, either with or without concomitant coracoplasty. METHODS: This study included 62 patients who underwent arthroscopic subscapularis repair either with coracoplasty (Group A, 35 patients) or without coracoplasty (Group B, 27 patients). Preoperative and postoperative visual analog scale pain scores, subjective shoulder values, University of California at Los Angeles shoulder scores, American Shoulder and Elbow Surgeon scores, subscapularis strength, and shoulder active range of motion (ROM) were assessed. Postoperative magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was performed 6 months postoperatively for structural integrity assessment. RESULTS: At 2-year follow-up, all functional scores and ROM improved significantly in both groups compared with preoperative values (p < 0.001). However, none of these values differed significantly between groups. On follow-up MRA or CTA images, although postoperative coracohumeral distance was significantly greater in Group A (8.4 mm +/- 2.3 mm versus 7.0 mm +/- 2.0 mm) (p = 0.018), the re-tear rates were not significantly different between groups (5/35 (14%) in Group A and 4/27 (15%) in Group B). CONCLUSIONS: For isolated subscapularis full-thickness tears, concomitant coracoplasty with arthroscopic repair did not produce better clinical outcomes or structural integrity than repair without coracoplasty. This suggests that concomitant coracoplasty may not be imperative during arthroscopic repair of isolated subscapularis full-thickness tears. LEVEL OF EVIDENCE: III.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Jae(김성재)
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
Choi, Yun Rak(최윤락)
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