Intra-articular Repair of an Isolated Partial Articular-Surface Tear of the Subscapularis Tendon

• Published in: The American journal of sports medicine 2005-12, Vol.33 (12), p.1825-1830
• Main Authors: Kim, Seung-Ho, Oh, Irvin, Park, Jun-Sic, Shin, Seong-Kee, Jeong, Woong-Kyo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthroscopy; Arthroscopy - methods; Biological and medical sciences; Care and treatment; Diagnosis; Diseases of the osteoarticular system; Endoscopy; Female; Humans; Injuries of the limb. Injuries of the spine; Investigative techniques, diagnostic techniques (general aspects); Knee; Male; Medical sciences; Middle Aged; Pain Measurement; Patient outcomes; Prospective Studies; Range of Motion, Articular - physiology; Recovery of Function - physiology; Retrospective Studies; Rotation; Shoulder; Shoulder injuries; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Sports injuries; Sports medicine; Surgeons; Suture Techniques; Tendon Injuries - diagnosis; Tendon Injuries - physiopathology; Tendon Injuries - surgery; Tendons - physiopathology; Tendons - surgery; Traumas. Diseases due to physical agents; Treatment Outcome
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546505278259

Background: Partial-thickness tear of the subscapularis tendon in the articular surface is common. Hypothesis: Intra-articular repair of a partial articular-surface tear of the subscapularis tendon will provide a successful outcome. Study Design: Case series; Level of evidence, 4. Methods: A total of 29 shoulders with an isolated partial articular-surface tear of the subscapularis tendon without another rotator cuff lesion were treated with arthroscopic intra-articular repair using suture anchors. Biceps tenodesis was performed in 16 patients. Outcomes were prospectively evaluated at a mean of 27 months (range, 19–41 months) using 3 objective (University of California at Los Angeles, American Shoulder and Elbow Surgeons Shoulder Index, Simple Shoulder Test) and 2 subjective (pain and function visual analog scales) measurements. Results: There were 21 men and 8 women, with a mean age of 54 years (range, 41–65 years). Tear widths were small (1 cm) in 13 shoulders. Twenty-six shoulders had articular cartilage erosion on the adjacent humeral head. Lesions of the biceps tendon were noted in 25 patients (partial tear in 15 shoulders; subluxation in 13 shoulders). Shoulder pain scores improved after surgery (5.0 ± 2.7 to 0.3 ± 0.7, P < .05). According to American Shoulder and Elbow Surgeons Shoulder Index scores, 18 were excellent; 10, good; and 1, fair. Internal rotation strength deficit improved from 32% to 4%. Twenty-six patients returned to more than 90% of previous activity. There were no surgical complications; tear size and biceps tenodesis did not affect outcome ( P > .05). Conclusion: Arthroscopic intra-articular repair of a partial articular-surface tear of the subscapularis tendon is an effective procedure that spares the intact tendon attachment in the bursal surface. Short-term outcomes were reliable by both objective and subjective measurements. Keywords: repair partial tear articular surface belly press subscapularis