Purpose
The purpose of this study was to prospectively assess the efficacy of arthroscopic
repair of isolated high-grade subscapularis (SSC) tendon lesions by means of clinical
follow-up combined with magnetic resonance imaging investigations.
Methods
Between January 2008 and September 2010, 11 patients (9 men and 2 women; mean age,
45 ± 10 years) with Lafosse type III or IV traumatic isolated SSC tendon lesions underwent
arthroscopic repair including tenodesis of the long head of the biceps tendon. All
patients were preoperatively assessed by clinical examination (Constant-Murley score
[CMS]) and contrast-enhanced magnetic resonance arthrography. At 1 year of follow-up,
specific clinical SSC tests, the CMS, and the loss of external rotation were evaluated.
A native magnetic resonance investigation was performed to assess the structural integrity
of the repair. The SSC muscle was compared with its preoperative condition regarding
fatty infiltration and size (cross-sectional area). Patient satisfaction was graded
from 1 (poor) to 4 (excellent).
Results
The mean time interval from trauma to surgery was 3.7 months. A concomitant lesion
of the biceps tendon was observed in 10 patients (91%). The mean CMS improved from
44 to 89 points (P < .001). The functional tests showed a significant increase in strength (P < .05) (belly-press test, 4.8 v 2.9; lift-off test, 4.8 v 2.9). The mean loss of external rotation at 0° of abduction was 10° compared with
the contralateral side (P < .05). Patient satisfaction was high. Magnetic resonance imaging evaluation showed
complete structural integrity of the tendon repair in all studies. The SSC showed
a significant decrease in fatty infiltration and increase in the cross-sectional area.
Conclusions
Arthroscopic repair of higher-grade isolated SSC lesions provides reliable tendon
healing accompanied by excellent functional results 1 year after surgery.
Level of Evidence
Level IV, prospective therapeutic case series.
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Article info
Publication history
Published online: April 07, 2014
Accepted:
February 20,
2014
Received:
November 11,
2013
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
