TY - JOUR
T1 - Clinical Outcomes and Tendon Integrity in Patients With Chronic Retracted Subscapularis Tear After Arthroscopic Single-Row Oblique Mattress Suture Repair Technique
AU - Jo, Yoon Geol
AU - Park, In
AU - Kang, Jun Seok
AU - Shin, Sang Jin
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: This work was supported by a National Research Foundation of Korea grant funded by the Korean government (NRF-2016R1D1A1A09919541). Full ICMJE author disclosure forms are available for this article online, as supplementary material. The authors report the following potential conflicts of interest or sources of funding: This work was supported by a National Research Foundation of Korea grant funded by the Korean government ( NRF-2016R1D1A1A09919541). Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Publisher Copyright:
© 2019 Arthroscopy Association of North America
PY - 2019/7
Y1 - 2019/7
N2 - Purpose: To evaluate clinical outcomes and tendon integrity in patients with chronic retracted subscapularis tears using an arthroscopic single-row oblique mattress suture repair technique. Methods: Patients with full-thickness subscapularis tears retracted to the glenoid level and with at least 2 years of follow-up were included. Tendon retraction level was measured on preoperative axial magnetic resonance images and confirmed during arthroscopic surgery. The subscapularis tendon was repaired arthroscopically using the single-row oblique mattress suture technique on the medial margin of the lesser tuberosity. Two double-loaded suture anchors were used to obtain firm fixation between the tendon and the footprint. Clinical outcomes were assessed for all patients preoperatively and postoperatively using active range of motion, a visual analog scale score for pain, and American Shoulder and Elbow Surgeons and Constant scores. To evaluate structural integrity of the repaired tendon, all patients underwent magnetic resonance imaging at 6 months and ultrasonography at 1 year after surgery. Results: The shoulder function of the 33 patients analyzed was improved significantly after a mean follow-up period of 26.3 ± 3.5 months compared with preoperative values (American Shoulder and Elbow Surgeons score of 52.0 ± 7.9 preoperatively vs 79.6 ± 7.0 at last follow-up, P < .001, and Constant score of 43.0 ± 13.4 preoperatively vs 76.7 ± 9.2 at last follow-up, P < .001). Postoperative active range of motion improved significantly in forward flexion, external rotation, and internal rotation (P < .001). The mean visual analog scale pain score decreased by 3.42 (5.2 ± 1.6 preoperatively vs 1.9 ± 1.4 at last follow-up, P < .001). In 4 patients (12.1%), subscapularis retears were confirmed on postoperative magnetic resonance imaging. Conclusions: Despite significant retraction, arthroscopic repair using a single-row oblique mattress suture technique in patients who had chronic subscapularis tears with retraction to the glenoid level yielded satisfactory clinical outcomes and reliable tendon healing. Level of Evidence: Level IV, therapeutic case series.
AB - Purpose: To evaluate clinical outcomes and tendon integrity in patients with chronic retracted subscapularis tears using an arthroscopic single-row oblique mattress suture repair technique. Methods: Patients with full-thickness subscapularis tears retracted to the glenoid level and with at least 2 years of follow-up were included. Tendon retraction level was measured on preoperative axial magnetic resonance images and confirmed during arthroscopic surgery. The subscapularis tendon was repaired arthroscopically using the single-row oblique mattress suture technique on the medial margin of the lesser tuberosity. Two double-loaded suture anchors were used to obtain firm fixation between the tendon and the footprint. Clinical outcomes were assessed for all patients preoperatively and postoperatively using active range of motion, a visual analog scale score for pain, and American Shoulder and Elbow Surgeons and Constant scores. To evaluate structural integrity of the repaired tendon, all patients underwent magnetic resonance imaging at 6 months and ultrasonography at 1 year after surgery. Results: The shoulder function of the 33 patients analyzed was improved significantly after a mean follow-up period of 26.3 ± 3.5 months compared with preoperative values (American Shoulder and Elbow Surgeons score of 52.0 ± 7.9 preoperatively vs 79.6 ± 7.0 at last follow-up, P < .001, and Constant score of 43.0 ± 13.4 preoperatively vs 76.7 ± 9.2 at last follow-up, P < .001). Postoperative active range of motion improved significantly in forward flexion, external rotation, and internal rotation (P < .001). The mean visual analog scale pain score decreased by 3.42 (5.2 ± 1.6 preoperatively vs 1.9 ± 1.4 at last follow-up, P < .001). In 4 patients (12.1%), subscapularis retears were confirmed on postoperative magnetic resonance imaging. Conclusions: Despite significant retraction, arthroscopic repair using a single-row oblique mattress suture technique in patients who had chronic subscapularis tears with retraction to the glenoid level yielded satisfactory clinical outcomes and reliable tendon healing. Level of Evidence: Level IV, therapeutic case series.
UR - http://www.scopus.com/inward/record.url?scp=85066338478&partnerID=8YFLogxK
U2 - 10.1016/j.arthro.2019.01.057
DO - 10.1016/j.arthro.2019.01.057
M3 - Article
C2 - 31167737
AN - SCOPUS:85066338478
VL - 35
SP - 1973
EP - 1981
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
SN - 0749-8063
IS - 7
ER -