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Recovery of subscapularis and shoulder function following arthroscopic treatment of isolated anterior and combined anterosuperior rotator cuff lesions

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

The purpose of the study was to evaluate the recovery of the subscapularis and shoulder function dependent on the type of lesion and type of surgical treatment, when compared to the non-affected contralateral shoulder. We hypothesized that regardless of type of lesion and performed surgical intervention, a significant muscle insufficiency as compared to the healthy contralateral side will remain.

Patients and methods

Sixty-eight patients (14 females and 54 males) with an anterior or anterosuperior cuff lesion at an average age of 55.7 ± 11.7 years (range 20–80 years) were prospectively evaluated up to 24 months. Intraoperatively, the lesions were classified according to current systems and treated by debridement or reconstruction. Pre- and postoperatively, the Constant Score (CS) as well as the belly-press angle (BPA) and back-to-hand distance (BHD) on the affected and on the contralateral shoulder was noted.

Results

29.4 % had an isolated subscapularis lesion whereas 69.1 % had concomitant supraspinatus pathology. In 17 patients an arthroscopic debridement and in 51 patients an arthroscopic repair were performed. Postoperatively, all patients revealed a significant improvement of the CS, BPA and BHD (p < 0.05) independent of the type of lesion or the surgical intervention. However, reconstruction of the subscapularis tendon resulted in significant differences of CS, BPA and BHD (p < 0.05) compared to the contralateral shoulder.

Conclusion

Reconstruction of subscapularis lesions cannot provide full subscapularis function since a residual subscapularis insufficiency remains, other than in patients with small partial tears treated with debridement alone.

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Authors and Affiliations

  1. Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Christian Gerhardt & Markus Scheibel

  2. Department of Trauma and Orthopaedic Surgery, Center of Musculoskeletal Surgery, Ulm University, Ulm, Germany

    Christoph Bartl

  3. Department of Trauma and Reconstructive Surgery, Friederikenstift Hospital, Hannover, Germany

    Christine Voigt, Helmut Lill & Jan Christoph Katthagen

  4. Departement of Trauma Surgery, Asklepios Klinik St. Georg, Hamburg, Germany

    Karl-Heinz Frosch

Authors
  1. Christian Gerhardt
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  2. Christoph Bartl
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  3. Christine Voigt
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  4. Helmut Lill
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  5. Markus Scheibel
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  6. Karl-Heinz Frosch
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  7. Jan Christoph Katthagen
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Correspondence to Christian Gerhardt.

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Gerhardt, C., Bartl, C., Voigt, C. et al. Recovery of subscapularis and shoulder function following arthroscopic treatment of isolated anterior and combined anterosuperior rotator cuff lesions. Arch Orthop Trauma Surg 136, 75–81 (2016). https://doi.org/10.1007/s00402-015-2334-3

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  • DOI: https://doi.org/10.1007/s00402-015-2334-3

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