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

Abstract

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.