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Title:

Subscapularis function and structural integrity after arthroscopic repair of isolated subscapularis tears.

Document type:
Journal Article; Research Support, Non-U.S. Gov't; nicht gelistet
Author(s):
Bartl, C; Salzmann, GM; Seppel, G; Eichhorn, S; Holzapfel, K; Wörtler, K; Imhoff, AB
Abstract:
Results of arthroscopic repair of isolated subscapularis tendon tears have not been widely studied. A detailed evaluation of subscapularis function with subscapularis strength quantification has not been performed to date.To evaluate postoperative subscapularis muscle function and to assess the clinical outcome and structural tendon integrity with postoperative magnetic resonance imaging after arthroscopic repair of isolated subscapularis tears.Case series; Level of evidence, 4.In a prospective study, isolated subscapularis tendon tears in 21 patients were treated with an all-arthroscopic repair. The average age of the study population was 43 years. The mean interval between trauma and surgery was 5.8 months. In 19 patients, a traumatic event caused the onset of symptoms. Subscapularis muscle function was assessed with specific clinical tests and the Constant scoring system. Postoperative subscapularis strength was evaluated with a custom-made electronic force measurement plate. All patients underwent postoperative magnetic resonance imaging to assess structural integrity of the repair.The average duration of follow-up was 27 months. The Constant score increased from 50 points preoperatively to 82 points postoperatively (P < .01). Most positive preoperative lift-off and belly-press tests were reversed by surgery, with a rate of 5 (24%) persistent positive tests after surgery. In operated shoulders, subscapularis strength in the belly-press (65 vs 87 N; P < .05) and the lift-off position (44 vs 68 N; P < .05) was significantly reduced compared with the contralateral shoulder. Magnetic resonance imaging revealed an intact repair in 20 patients. Atrophy of the upper subscapularis muscle portion was present in about one-fourth of the patients and in all patients with a positive postoperative belly-press test.Arthroscopic repair of isolated subscapularis tendon tears achieves substantial improvement of shoulder function and a low rerupture rate. Despite excellent clinical results, a significant postoperative subscapularis strength deficit compared with the contralateral shoulder persists that can be quantified with use of the force measurement plate. Atrophy of the upper subscapularis muscle is present in 25% of the patients in the postoperative course.
Journal title abbreviation:
Am J Sports Med
Year:
2011
Journal volume:
39
Journal issue:
6
Pages contribution:
1255-62
Language:
eng
Fulltext / DOI:
doi:10.1177/0363546510396317
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/21335343
Print-ISSN:
0363-5465
TUM Institution:
Fachgebiet Sportorthopädie (Prof. Imhoff); Klinik und Poliklinik für Orthopädie und Sportorthopädie
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