JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

ISSN: Active
eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Does subscapularis tears combined with supraspinatus tears affect postoperative functional outcomes?
Abstract
Aims: Roughly 50% of rotator cuff tears includes a tear in the subscapularis tendon. We conducted a comparative analysis of the functional outcomes following arthroscopic repair in patients with a tear in both the supraspinatus and subscapularis tendons, as well as those with a rupture solely in the supraspinatus tendon. Our hypothesis posits that the functional outcomes after surgery for rotator cuff tears, specifically those with tears including subscapularis tendon, are inferior compared to tears that only involve the supraspinatus tendon.
Methods: We classified patients who had arthroscopic repair for a rotator cuff tear in our clinic from January 2017 to April 2022 into two groups. The study comprised patients who received arthroscopic surgery for a diagnosed rotator cuff injury. The study excluded individuals who were younger than 18, individuals with large tears that could not be repaired, individuals with paralabral cysts, individuals with glenohumeral arthritis, individuals who had undergone labrum tear repair or slap lesion repair, individuals with concomitant neurovascular damage, and individuals who had a follow-up period of less than 6 months, patients who benefit from physiotherapy and medical treatment for 6 months. Following the application of exclusion criteria, a total of 39 patients were selected to participate in the study. The presence of a rotator cuff injury was verified through arthroscopy after being detected using clinical tests such as Jobe, drop arm test, Neer sign, lift-off and belly-press tests, and radiographic evidence such as magnetic resonance imaging. Patients who received subscapularis repair together with a supraspinatus tear were categorised as Group 1 (n=14), while those who just had supraspinatus surgery without any subscapularis tears were categorized as Group 2 (n=25). We recorded the demographic information. At the last postoperative outpatient clinic follow-up, both groups were compared in terms of mortality, laboratory parameters, radiological findings, visual analogue scale (VAS), Constant-Murley score1, American Shoulder and Elbow Surgeons score (ASES)2, and University of California Los Angeles (UCLA) scores.3 Postoperative satisfaction levels were categorised into four groups: very satisfied, satisfied, undecided, and dissatisfied.
Results: The groups did not show any significant differences in terms of age, gender distribution, and follow-up periods (p>0.05). There was no statistically significant disparity observed between the groups in relation to VAS, Constant-Murley score, ASES, and UCLA ratings assessed during the final postoperative outpatient clinic follow-up (p>0.05). There were no instances of re-rupture observed in any patient throughout the postoperative follow-up period. The postoperative satisfaction ratings show no significant difference between the two groups (p>0.05).
Conclusion: Our findings indicate that the outcomes of patients who received a surgical repair of rotator cuff tendons including subscapularis were at least as successful as those who underwent surgery for just supraspinatus tendon rupture. There is no basis to believe that arthroscopic repair will have a detrimental impact on the functional outcomes of individuals with rotator cuff tears which includes subscapularis tendon tears.

Keywords : Supraspinatus, subscapularis, shoulder arthroscopy, postoperative function, repair

Download Article


1. Constant CR, Murley AH. A clinical method of functionalassessment of the shoulder. Clin Orthop Relat Res. 1987;(214):160-164.
2. Michener LA, McClure PW, Sennett BJ. American Shoulder andElbow Surgeons Standardized Shoulder Assessment Form, patientself-report section: reliability, validity, and responsiveness. JShoulder Elbow Surg. 2002;11(6):587-594. doi:10.1067/mse.2002.127096
3. Ellman H, Hanker G, Bayer M. Repair of the rotator cuff. end-result study of factors influencing reconstruction. J Bone JointSurg Am. 1986;68(8):1136-1144.
4. Yamamoto A, Takagishi K, Osawa T, et al. Prevalence and riskfactors of a rotator cuff tear in the general population. J ShoulderElbow Surg. 2010;19(1):116-120. doi:10.1016/j.jse.2009.04.006
5. Colvin AC, Egorova N, Harrison AK, Moskowitz A, FlatowEL. National trends in rotator cuff repair. J Bone Joint Surg Am.2012;94(3):227-233. doi:10.2106/JBJS.J.00739
6. Agout C, Berhouet J, Bouju Y, et al. Clinical and anatomic resultsof rotator cuff repair at 10 years depend on tear type. Knee SurgSports Traumatol Arthrosc. 2018;26(8):2490-2497. doi:10.1007/s00167-018-4854-1
7. Malavolta EA, Chang VYP, Montechi JMN, et al. Does asubscapularis tear combined with a posterosuperior rotator cufftear affect postoperative functional outcomes? J Shoulder ElbowSurg. 2020;29(12):2523-2529. doi:10.1016/j.jse.2020.03.044
8. Richards DP, Burkhart SS, Lo IK. Subscapularis tears: arthroscopicrepair techniques. Orthop Clin North Am. 2003;34(4):485-498.doi:10.1016/s0030-5898(03)00096-8
9. Park JY, Chung SW, Lee SJ, et al. Combined subscapularis tearsin massive posterosuperior rotator cuff tears: do they affectpostoperative shoulder function and rotator cuff integrity? Am JSports Med. 2016;44(1):183-190. doi:10.1177/0363546515610552
10. Yoo JC, McGarry MH, Jun BJ, Scott J, Lee TQ. The influence ofpartial subscapularis tendon tears combined with supraspinatustendon tears. J Shoulder Elbow Surg. 2014;23(6):902-908. doi:10.1016/j.jse.2013.09.015
11. Garavaglia G, Ufenast H, Taverna E. The frequency of subscapularistears in arthroscopic rotator cuff repairs: a retrospective studycomparing magnetic resonance imaging and arthroscopicfindings. Int J Shoulder Surg. 2011;5(4):90-94. doi:10.4103/0973-6042.91000
12. Gyftopoulos S, O'Donnell J, Shah NP, Goss J, Babb J, Recht MP.Correlation of MRI with arthroscopy for the evaluation of thesubscapularis tendon: a musculoskeletal division's experience.Skeletal Radiol. 2013;42(9):1269-1275. doi:10.1007/s00256-013-1669-5
13. Furukawa R, Morihara T, Arai Y, et al. Diagnostic accuracy ofmagnetic resonance imaging for subscapularis tendon tears usingradial-slice magnetic resonance images. J Shoulder Elbow Surg.2014;23(11):e283-e290. doi:10.1016/j.jse.2014.03.011
14. Malavolta EA, Assuncao JH, Guglielmetti CL, et al. Accuracy ofpreoperative MRI in the diagnosis of subscapularis tears. ArchOrthop Trauma Surg. 2016;136(10):1425-1430. doi:10.1007/s00402-016-2507-8
15. Lafosse L, Lanz U, Saintmard B, Campens C. Arthroscopicrepair of subscapularis tear: surgical technique and results.Orthop Traumatol Surg Res. 2010;96(8):S99-S108. doi:10.1016/j.otsr.2010.09.009
16. Park MC, Elattrache NS, Ahmad CS, Tibone JE. "Transosseous-equivalent" rotator cuff repair technique. Arthroscopy.2006;22(12):1360.e1-1360.e5. doi:10.1016/j.arthro.2006.07.017
17. Thigpen CA, Shaffer MA, Gaunt BW, Leggin BG, Williams GR,Wilcox III RB. The American Society of Shoulder and ElbowTherapists' consensus statement on rehabilitation followingarthroscopic rotator cuff repair. J Shoulder Elbow Surg.2016;25(4):521-535. doi:10.1016/j.jse.2015.12.018
18. Yoon TH, Kim SJ, Choi YR, Shin JC, Alruwaili SH, Chun YM.Anterior rotator cable disruption does not affect outcomes inrotator cuff tear with subscapularis involvement. Knee Surg SportsTraumatol Arthrosc. 2021;29(1):154-161. doi:10.1007/s00167-020-05891-z
19. Longo UG, Carnevale A, Piergentili I, et al. Retear rates afterrotator cuff surgery: a systematic review and meta-analysis. BMCMusculoskelet Disord. 2021;22(1):749. doi:10.1186/s12891-021-04634-6
20. Ide J, Tokiyoshi A, Hirose J, Mizuta H. Arthroscopic repair oftraumatic combined rotator cuff tears involving the subscapularistendon. J Bone Joint Surg Am. 2007;89(11):2378-2388. doi:10.2106/JBJS.G.00082
Article available in :
Volume 7, Issue 1, 2024
Page : 105-109
https://doi.org/10.32322/jhsm.1363275
Article Information
Received : 19 Eyl 2023
Accepted : 02 Oca 2024
Published : 15 Oca 2024
Corresponding Author :

Ozan Altun: Department of Orthopedics and Traumatology, Faculty of Medicine, Karabük University Karabük, Turkey

[email protected]
Citation : Altun O, Gül O, Ergişi Y, Tıkman M, Kekeç H, Çömez O. Does subscapularis tears combined with supraspinatus tears affect postoperative functional outcomes?. J Health Sci Med. 2024;7(1):105-109.

Read: 86
Cited: 0
Download : 110
_Footer