Abstract
The purpose of this study was to assess clinical and anatomic outcomes of arthroscopic repair of full-thickness tears of subscapularis tendon(SSC). 18 consecutive patients who underwent arthroscopic repair of SSC were enrolled. 15 men and 3 women, whose average age at surgery was 60.7 years old. Some kind of history of trauma was seen in 15 patients. The mean postoperative follow-up period was 17 months. Surgery was performed mainly in subacromial approaches, viewed from the anterosuperolateral portal. Mobilization of retracted tendon was made in chronic degenerative case, with care of musculocutaneous and axillary nerves. Fixation of the tendon to its footprint was done with several metal suture anchors in double-row fashion. A solitary SSC tear was seen in 2 cases, with supraspinatus tear in 7, with supraspinatus and infraspinatus tears in 9. Diminished long head of biceps tendon (LHBT) was seen in 6 cases, and partial injury of LHBT in 10. Arthroscopic biceps tenodesis was performed in 4 cases. We evaluated the clinical measures using the JOA-shoulder score (JOA-SS), QuickDASH, range-of-motion, and muscle strength. Also we assessed repair integrity using MRI T2-weighted imaging 6 and 12 months postoperatively. The average size of full-thickness defect of SSC was 25.6mm in coronal dimension and 19.4mm in sagittal. No complications including nerve injury were observed in all cases. JOA-SS improved from 51.5 to 92, QuickDASH also changed from 76.1 to 13.6. Internal rotation was enhanced from L4 to L1, flexion improved from 100° to 163°. Muscle strength using MicroFET, internal rotation improved from 59.8N to 98N. No apparent re-tear was observed 6 and 12 months postoperatively. We conclude that arthroscopic SSC repair is a safe and effective procedure because the surgeon will be able to diagnose and mobilize precisely under direct vision, and useful for simultaneous repair of torn supra- and infraspinatus tendons.
