Abstract
Full-thickness tears of the subscapularis were classified by tear size and tendon retraction at arthroscopic evaluation. 20 consecutive patients (20 shoulders) with traumatic anterosuperior rotator cuff tear were evaluated in this study. There were 17 men and 3 women; their mean age was 61.7 years (range 44 to 79 years). When the superior 1/3 (superior 1/2 of tendon portion) of the attachment was torn, the tear size was classified as grade 1 (n=5), when the superior 2/3 (all tendon portion) of the attachment was involved, the classification was grade 2 (n=15), when all (tendon and muscular portion) of the attachment was torn, as grade 3 (n=0). When the tear edge was over the lateral articular cartilage margin at neutral rotation, tendon retraction was classified as minimal (n=2), when in an area lateral to the glenoid surface, as moderate (n=8), and when on the glenoid surface level or in an area medial to the glenoid surface, as severe (n=10). Larger tear had more severe tendon retraction. The inferior muscular portion of the subscapularis was retained in all patients. As viewed from the anterosuperior portal, the attachment of the inferior muscular portion of the subscapularis to the humerus was detected as a guide to find the torn subscapularis tendon. The incidence of recurrent tears was significantly higher in patients with severe- (6 of 10 patients) in comparison to minimal or moderate tendon retractions (1 of 10 patients) (p = .0191).
