Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 27, Issue 12, pp 4021–4031 | Cite as

Repair of Lafosse I subscapularis lesions brings no benefit in anterosuperior rotator cuff reconstruction

  • Barbara Wirth
  • Sebastian Kunz
  • Hans-Kaspar Schwyzer
  • Matthias Flury
  • Maximilian Lenz
  • Laurent AudigéEmail author



Optimal management of partial anterosuperior rotator cuff tears is unknown. Our aim was to compare clinical and subjective outcomes of supraspinatus (SSP) repair patients treated with or without repair of an associated superior subscapularis (SSC) partial tear.


SSP repair patients with an associated partial (Lafosse I) tear of the superior SSC tendon were retrospectively examined. Baseline and operative data and the outcomes of shoulder range of motion (ROM), pain level, strength, Constant-Murley Score, complications at 6 months as well as patient-reported Oxford Shoulder Score, Subjective Shoulder Value, and satisfaction at 6- and 24-month post-surgery were compared between patients with and without a repaired SSC tear. Mixed models and propensity-score matching were used to adjust baseline group differences.


Of 75 eligible patients, 34 had an SSC repair and were younger with better baseline function. Non-repair surgeries were significantly shorter by 34 min (95% CI 23–45; p < 0.001). There were no group differences in the clinical and patient-rated outcome scores at both follow-ups (n.s.) as well as in pain, muscle strength in abduction, ROM, the 6-month complication risk (risk difference − 1.9%), and satisfaction with postoperative shoulder condition (n.s.).


We could not show a functional or subjective benefit of repairing cranial partial tears of the SSC tendon over debridement only in the setting of an SSP reconstruction with 24 months of follow-up. A longer operative duration is expected if a partial SSC tear repair is performed.

Level of evidence



Shoulder Anterosuperior rotator cuff lesion Partial subscapularis tear Lafosse I Arthroscopic repair Functional outcomes Patient-reported outcomes 



Constant-Murley shoulder score


Magnetic resonance image


Numeric rating scale


Oxford shoulder score


Propensity score(s)


Rotator cuff


Range of motion


Standard deviation






Subjective shoulder value


Standardized difference



The authors would like to thank M. Wilhelmi, PhD (medical writer at Schulthess Clinic) for the editing and final preparation of this manuscript.

Author contributions

BW carried out the surgeries, participated in the registry documentation, formulated the study question, participated in the study design, interpreted the results, and drafted the manuscript. SK performed intensive registry documentation and drafted the manuscript. H-KS carried out the surgeries and participated in the registry documentation, MF conceived the local register, carried out the surgeries, and participated in the registry documentation, ML reviewed carefully all patients for the occurrence of adverse events, LA conceived the local registry, participated in the study design and performed the statistical analyses and drafted the manuscript. All authors read and approved the final manuscript.


No external funding was used.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

167_2019_5681_MOESM1_ESM.docx (46 kb)
Supplementary file1 (DOCX 46 kb)
167_2019_5681_MOESM2_ESM.docx (186 kb)
Supplementary file2 (DOCX 186 kb)


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  • Barbara Wirth
    • 1
  • Sebastian Kunz
    • 2
    • 3
  • Hans-Kaspar Schwyzer
    • 1
  • Matthias Flury
    • 1
    • 4
  • Maximilian Lenz
    • 1
    • 5
  • Laurent Audigé
    • 1
    • 2
    Email author
  1. 1.Shoulder and Elbow Surgery DepartmentSchulthess ClinicZurichSwitzerland
  2. 2.Research and Development DepartmentSchulthess ClinicZurichSwitzerland
  3. 3.Department of Orthopaedic Surgery and TraumatologyUniversity Hospital of BaselBaselSwitzerland
  4. 4.Center for Orthopaedics and NeurosurgeryIn-MotionWallisellenSwitzerland
  5. 5.Department of Orthopaedic and Trauma SurgeryUniversity Hospital of CologneCologneGermany

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