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MUSCULOSKELETAL SURGERY

, Volume 99, Supplement 1, pp 37–42 | Cite as

Strength recovery after arthroscopic anterosuperior cuff repair: analysis of a consecutive series

  • E. VisonàEmail author
  • P. Paladini
  • G. Merolla
  • S. Cerciello
  • G. Porcellini
Original Article

Abstract

Purpose

The purpose of this study was to look at the functional outcomes of arthroscopic repair of anterosuperior rotator cuff tears.

Methods

Sixty-one patients who underwent arthroscopic repair of anterosuperior cuff tears were retrospectively reviewed. At a minimum 6 months of follow-up, shoulder functional outcome scores including the Constant score (CS), simple shoulder test (SST) and visual analogic scale (VAS) were collected. Strength recovery for supraspinatus and subscapularis was investigated.

Results

All patients (mean age 59 ± 7) were available at a mean follow-up of 18 ± 7 months. The average CS improved from 30.8 ± 10.2 preoperatively to 76.5 ± 12.0 postoperatively, average SST from 2.6 ± 2.0 to 8.8 ± 2.9 and average VAS pain scale from 3.8 ± 1 to 0.5 ± 0.5 (p < 0.0001). Strength at belly-press and Jobe tests significantly improved (p < 0.0001). All patients with the exception of one were satisfied with the intervention.

Conclusions

Arthroscopic repair of anterosuperior rotator cuff tears provides a significant improvement in pain relief and shoulder function. Strength recovery is demonstrated in medium correlation with tendon healing.

Level of evidence

Level IV, therapeutic case series.

Keywords

Shoulder Rotator cuff Muscle strength dynamometer Arthroscopy Subscapularis Tendon injuries 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

  1. 1.
    Edwards TB et al (2006) Arthroscopic debridement in the treatment of patients with isolated tears of the subscapularis. Arthroscopy 22(9):941–946CrossRefPubMedGoogle Scholar
  2. 2.
    Bennett WF (2001) Subscapularis, medial, and lateral head coracohumeral ligament insertion anatomy. Arthroscopic appearance and incidence of “hidden” rotator interval lesions. Arthroscopy 17(2):173–180CrossRefPubMedGoogle Scholar
  3. 3.
    Gerber C, Terrier F, Ganz R (1985) The role of the coracoid process in the chronic impingement syndrome. J Bone Joint Surg Br 67(5):703–708PubMedGoogle Scholar
  4. 4.
    Gerber C, Sebesta A (2000) Impingement of the deep surface of the subscapularis tendon and the reflection pulley on the anterosuperior glenoid rim: a preliminary report. J Shoulder Elb Surg 9(6):483–490CrossRefGoogle Scholar
  5. 5.
    Lo IK, Burkhart SS (2003) The etiology and assessment of subscapularis tendon tears: a case for subcoracoid impingement, the roller-wringer effect, and TUFF lesions of the subscapularis. Arthroscopy 19(10):1142–1150CrossRefPubMedGoogle Scholar
  6. 6.
    Lo IK, Parten PM, Burkhart SS (2003) Combined subcoracoid and subacromial impingement in association with anterosuperior rotator cuff tears: an arthroscopic approach. Arthroscopy 19(10):1068–1078CrossRefPubMedGoogle Scholar
  7. 7.
    Kim TK, Rauh PB, McFarland EG (2003) Partial tears of the subscapularis tendon found during arthroscopic procedures on the shoulder: a statistical analysis of sixty cases. Am J Sports Med 31(5):744–750PubMedGoogle Scholar
  8. 8.
    Bennett WF (2003) Arthroscopic repair of anterosuperior (supraspinatus/subscapularis) rotator cuff tears: a prospective cohort with 2- to 4-year follow-up. Classification of biceps subluxation/instability. Arthroscopy 19(1):21–33CrossRefPubMedGoogle Scholar
  9. 9.
    Nho SJ et al (2010) Arthroscopic repair of anterosuperior rotator cuff tears combined with open biceps tenodesis. Arthroscopy 26(12):1667–1674CrossRefPubMedGoogle Scholar
  10. 10.
    Edwards TB et al (2005) Repair of tears of the subscapularis. J Bone Joint Surg Am 87(4):725–730CrossRefPubMedGoogle Scholar
  11. 11.
    Nove-Josserand L et al (1994) Isolated lesions of the subscapularis muscle. Apropos of 21 cases. Rev Chir Orthop Reparatrice Appar Mot 80(7):595–601PubMedGoogle Scholar
  12. 12.
    Gerber C, Hersche O, Farron A (1996) Isolated rupture of the subscapularis tendon. J Bone Joint Surg Am 78(7):1015–1023PubMedGoogle Scholar
  13. 13.
    Burkhart SS, Tehrany AM (2002) Arthroscopic subscapularis tendon repair: technique and preliminary results. Arthroscopy 18(5):454–463CrossRefPubMedGoogle Scholar
  14. 14.
    Bennett WF (2003) Arthroscopic repair of isolated subscapularis tears: a prospective cohort with 2- to 4-year follow-up. Arthroscopy 19(2):131–143CrossRefPubMedGoogle Scholar
  15. 15.
    Lafosse L et al (2010) Arthroscopic repair of subscapularis tear: surgical technique and results. Orthop Traumatol Surg Res 96(8 Suppl):S99–S108CrossRefPubMedGoogle Scholar
  16. 16.
    Adams CR, Schoolfield JD, Burkhart SS (2008) The results of arthroscopic subscapularis tendon repairs. Arthroscopy 24(12):1381–1389CrossRefPubMedGoogle Scholar
  17. 17.
    Nove-Josserand L et al (2012) Clinical and structural results of arthroscopic repair of isolated subscapularis tear. J Bone Joint Surg Am 94(17):e125CrossRefPubMedGoogle Scholar
  18. 18.
    Burkhart SS, Brady PC (2006) Arthroscopic subscapularis repair: surgical tips and pearls A to Z. Arthroscopy 22(9):1014–1027CrossRefPubMedGoogle Scholar
  19. 19.
    Lafosse L et al (2007) Structural integrity and clinical outcomes after arthroscopic repair of isolated subscapularis tears. J Bone Joint Surg Am 89(6):1184–1193CrossRefPubMedGoogle Scholar
  20. 20.
    Paribelli G, Boschi S (2005) Complete subscapularis tendon visualization and axillary nerve identification by arthroscopic technique. Arthroscopy 21(8):1016CrossRefPubMedGoogle Scholar
  21. 21.
    Bartl C, Imhoff AB (2007) Management of isolated subscapularis tendon tears. Orthopade 36(9):848–854CrossRefPubMedGoogle Scholar
  22. 22.
    Toussaint B et al (2012) Arthroscopic repair of subscapularis tears: preliminary data from a prospective multicentre study. Orthop Traumatol Surg Res 98(8 Suppl):S193–S200CrossRefPubMedGoogle Scholar
  23. 23.
    Denard PJ et al (2012) Long-term outcome of a consecutive series of subscapularis tendon tears repaired arthroscopically. Arthroscopy 28(11):1587–1591CrossRefPubMedGoogle Scholar
  24. 24.
    Katthagen JC et al (2013) Anterosuperior rotator cuff tears: rupture configurations and results after arthroscopic therapy—a prospective study. Unfallchirurg 116(2):151–160CrossRefPubMedGoogle Scholar
  25. 25.
    Kim DY et al (2012) Arthroscopic percutaneous repair of anterosuperior rotator cuff tear including biceps long head: a 2-year follow-up. Clin Orthop Surg 4(4):284–292PubMedCentralCrossRefPubMedGoogle Scholar
  26. 26.
    Schnaser E et al (2013) Arthroscopic treatment of anterosuperior rotator cuff tears. Orthopedics 36(11):e1394–e1400CrossRefPubMedGoogle Scholar
  27. 27.
    Maqdes A et al (2014) Does preoperative subscapularis fatty muscle infiltration really matter in anterosuperior rotator cuff tears repair outcomes? A prospective multicentric study. Orthop Traumatol Surg Res 100(5):485–488CrossRefPubMedGoogle Scholar
  28. 28.
    Patte D (1990) Classification of rotator cuff lesions. Clin Orthop Relat Res 254:81–86PubMedGoogle Scholar
  29. 29.
    Fuchs B et al (1999) Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elb Surg 8(6):599–605CrossRefGoogle Scholar
  30. 30.
    Tokish JM et al (2003) The belly-press test for the physical examination of the subscapularis muscle: electromyographic validation and comparison to the lift-off test. J Shoulder Elb Surg 12(5):427–430CrossRefGoogle Scholar
  31. 31.
    Gilmer B et al (2007) Normalization of the subscapularis belly-press test. J Shoulder Elb Surg 16(4):403–407CrossRefGoogle Scholar
  32. 32.
    Paladini P et al (2012) Long-term subscapularis strength assessment after Bristow-Latarjet procedure: isometric study. J Shoulder Elb Surg 21(1):42–47CrossRefGoogle Scholar
  33. 33.
    Lafosse L, Van Raebroeckx A, Brzoska R (2006) A new technique to improve tissue grip: “the lasso-loop stitch”. Arthroscopy 22(11):1246e1–1246e3CrossRefGoogle Scholar
  34. 34.
    Lo IK, Burkhart SS (2003) The comma sign: an arthroscopic guide to the torn subscapularis tendon. Arthroscopy 19(3):334–337CrossRefPubMedGoogle Scholar
  35. 35.
    Kontakis GM (2007) The long biceps tendon as the main cause of shoulder pain in rotator cuff tears. Orthopedics 30(3):185PubMedGoogle Scholar
  36. 36.
    Garavaglia G, Ufenast H, Taverna E (2011) The frequency of subscapularis tears in arthroscopic rotator cuff repairs: a retrospective study comparing magnetic resonance imaging and arthroscopic findings. Int J Shoulder Surg 5(4):90–94PubMedCentralCrossRefPubMedGoogle Scholar
  37. 37.
    Deutsch A et al (1997) Traumatic tears of the subscapularis tendon. Clinical diagnosis, magnetic resonance imaging findings, and operative treatment. Am J Sports Med 25(1):13–22CrossRefPubMedGoogle Scholar
  38. 38.
    Flury MP et al (2006) Rupture of the subscapularis tendon (isolated or in combination with supraspinatus tear): when is a repair indicated? J Shoulder Elb Surg 15(6):659–664CrossRefGoogle Scholar
  39. 39.
    Di Schino M, Augereau B, Nich C (2012) Does open repair of anterosuperior rotator cuff tear prevent muscular atrophy and fatty infiltration? Clin Orthop Relat Res 470(10):2776–2784PubMedCentralCrossRefPubMedGoogle Scholar
  40. 40.
    Kim SJ et al (2015) Arthroscopic repair of a significant (>50 %) partial-thickness subscapularis tear concomitant with a full-thickness supraspinatus tear: technical considerations for subscapularis repair (transtendon technique versus tear completion). J Shoulder Elb Surg. doi: 10.1016/j.jse.2014.10.009 Google Scholar

Copyright information

© Istituto Ortopedico Rizzoli 2015

Authors and Affiliations

  • E. Visonà
    • 1
    • 2
    Email author
  • P. Paladini
    • 1
  • G. Merolla
    • 1
  • S. Cerciello
    • 1
    • 3
  • G. Porcellini
    • 1
  1. 1.Unit of Shoulder and Elbow SurgeryD. Cervesi HospitalCattolicaItaly
  2. 2.ULSS 17Ospedale di EsteEsteItaly
  3. 3.Università Cattolica del Sacro CuoreRomeItaly

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