Subscapularis tendon tears

Background: Subcoracoid impingement has been implicated as a cause of anterior shoulder pain and subscapularis tendon tears. Purpose/Hypothesis: The purpose of this study was to evaluate the bony anatomy of the coracoid process and the subcoracoid space. We hypothesized that age-related changes that may contribute to subcoracoid impingement occur in the subcoracoid space. Study Design: Descriptive laboratory study. Methods: In total, 418 skeletal shoulder specimens were included in this study. We utilized 214 shoulders from a young cohort (25-35 years of age) and 204 shoulders from an older cohort (>55 years of age) for comparison. We evaluated several morphological characteristics of the coracoid process and the subcoracoid space: coracoid width, coracoid shape, coracoid thickness, and subcoracoid distance. Each coracoid was observed for the presence of spurring or other morphological changes. Results: The mean anteroposterior (AP) thickness of the coracoid tip was 7.9 and 9.4 mm in our young female and male cohorts, respectively, while the mean AP thickness was 8.1 and 9.7 mm in our older female and male cohorts, respectively. The coracoid tip was hooked in 31 of 108 young female shoulders compared with 55 of 102 older female shoulders, and the coracoid tip was hooked in 25 of 106 young male shoulders compared with 45 of 102 older male shoulders. The mean subcoracoid distance in neutral rotation was 14.8 and 12.5 mm in young and older female shoulders, respectively, while the mean subcoracoid distance in internal rotation in these same cohorts was 8.7 and 7.0 mm, respectively. The mean subcoracoid distance in neutral rotation was 14.8 and 13.3 mm in young and older male shoulders, respectively, while the mean subcoracoid distance in internal rotation was 8.6 and 8.1 mm in young and older male shoulders, respectively. Conclusion: The principal findings of our study demonstrate that anatomic changes implicated in subcoracoid impingement may be developmental and worsen with age. The subcoracoid space was narrower in our older cohort of shoulders. Additionally, these older shoulders also had a greater AP width and a more hooked coracoid compared with young shoulders. Clinical Relevance: Narrowing of the subcoracoid space has been shown to be implicated as a cause of anterior shoulder pain and subscapularis tendon tears. This is the first study to show that the morphological changes implicated in subcoracoid impingement become more prevalent with age. This may help to explain the increasing prevalence of subscapularis tendon tears in older patients. Furthermore, subcoracoid decompression may be seen as an option for older patients with anterior shoulder pain and subscapularis tendon tears.

Download Full-text

Arthroscopic Repair of Subscapularis Tendon Tears

Rotator Cuff Injuries ◽

10.1007/978-3-319-63668-9_6 ◽

2017 ◽

pp. 103-117

Author(s):

Gerhard G. Konrad

Keyword(s):

Arthroscopic Repair ◽

Subscapularis Tendon ◽

Tendon Tears

Download Full-text

Diagnosis of subscapularis tendon tears: Are available diagnostic tests pertinent for a positive diagnosis?

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2012.09.008 ◽

2012 ◽

Vol 98 (8) ◽

pp. S178-S185 ◽

Cited By ~ 16

Author(s):

J. Barth ◽

S. Audebert ◽

B. Toussaint ◽

C. Charousset ◽

A. Godeneche ◽

...

Keyword(s):

Diagnostic Tests ◽

Subscapularis Tendon ◽

Positive Diagnosis ◽

Tendon Tears

Download Full-text

Poor Agreement on Classification and Treatment of Subscapularis Tendon Tears

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2015.08.006 ◽

2016 ◽

Vol 32 (2) ◽

pp. 246-251.e1 ◽

Cited By ~ 10

Author(s):

Mia Smucny ◽

Edward C. Shin ◽

Alan L. Zhang ◽

Brian T. Feeley ◽

Tatiana Gajiu ◽

...

Keyword(s):

Subscapularis Tendon ◽

Poor Agreement ◽

Tendon Tears ◽

Classification And Treatment

Download Full-text

The Coracohumeral Distance in Shoulders With Traumatic and Degenerative Subscapularis Tendon Tears

The American Journal of Sports Medicine ◽

10.1177/0363546515611653 ◽

2015 ◽

Vol 44 (1) ◽

pp. 198-201 ◽

Cited By ~ 13

Author(s):

Maurice Balke ◽

Marc Banerjee ◽

Oliver Greshake ◽

Juergen Hoeher ◽

Bertil Bouillon ◽

...

Keyword(s):

Subscapularis Tendon ◽

Tendon Tears

Download Full-text

Subscapularis Tendon Tears: Detection and Grading at MR Arthrography

Radiology ◽

10.1148/radiology.213.3.r99dc03709 ◽

1999 ◽

Vol 213 (3) ◽

pp. 709-714 ◽

Cited By ~ 163

Author(s):

Christian W. A. Pfirrmann ◽

Marco Zanetti ◽

Dominik Weishaupt ◽

Christian Gerber ◽

Juerg Hodler

Keyword(s):

Mr Arthrography ◽

Subscapularis Tendon ◽

Tendon Tears

Download Full-text

Outcomes of Arthroscopic and Open Surgical Repair of Isolated Subscapularis Tendon Tears

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2012.02.018 ◽

2012 ◽

Vol 28 (9) ◽

pp. 1306-1314 ◽

Cited By ~ 47

Author(s):

Nathan A. Mall ◽

Jaskarndip Chahal ◽

Wendell M. Heard ◽

Bernard R. Bach ◽

Charles A. Bush-Joseph ◽

...

Keyword(s):

Surgical Repair ◽

Subscapularis Tendon ◽

Open Surgical Repair ◽

Tendon Tears

Download Full-text

Concordância interobservador na avaliação de lesões do tendão subescapular usando imagens de Ressonância Nuclear Magnética

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v8i1.3821 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Aleixo Abreu Tanure ◽

Roberto Barreto Maia ◽

Thiago Alencar Fortaleza ◽

Luis Guilherme Rosifini Alves Rezende ◽

Adriana Vieira Pedreira Cabral ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rotator Cuff ◽

Mr Imaging ◽

Interobserver Agreement ◽

Preoperative Magnetic Resonance Imaging ◽

Subscapularis Tendon ◽

Resonance Imaging ◽

Preoperative Magnetic Resonance ◽

Tendon Tears

Introdução: As lesões do tendão musculo subescapular (TMSE) do manguito rotador passaram a ter aumento de sua incidência com as avançadas técnicas de diagnostico por imagem e artroscópicas. A Ressonância Nuclear Magnética (RM) apresenta boa sensibilidade e especificidade permitindo adequada acurácia diagnóstico. Objetivo: avaliação da concordância interobservador da RM para Lesões do TMSE comparada à artroscopia. Métodologia: 49 pacientes sintomáticos foram submetidos à RM para diagnóstico de lesão do TMSE e avaliação da Classificação de Lafosse, tendo sua concordância avaliada através da Artroscopia diagnostica. Resultados: A acurácia global foi 68% para concordância diagnóstica da Lesão do TMSE e 57,1% para concordância na classificação de Lafosse. Discussão: obteve-se concordância para o diagnóstico de Lesão ou ausência de Lesão do TMSE de 0,49 e a concordância para a Classificação de Lafosse foi de 0,30. Conclusão: o diagnóstico da lesão do TMSE através da RM é de difícil realização.Descritores: Manguito Rotador; Artroscopia; Imagem por Ressonância Magnética.ReferênciasTicker JB, Warner JJ. Single-tendon tears of the rotator cuff: evaluation and treatment of subscapularis tears and principles of treatment for supraspinatus tears. Orthop Clin North Am. 1997; 28(1):99-116.  Codman EA. Rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. The Shoulder. 2nd Ed. Boston: Thomas Todd; 1934. p. 262-312.  Deutsch A, Altchek DW, Veltri DM, Potter HG, Warren RF. Traumatic tears of the subscapularis tendon. Clinical diagnosis, magnetic resonance imaging findings, and operative treatment. Am J Sports Med. 1997;25(1):13-22.Li XX, Schweitzer ME, Bifano JA, Lerman J, Manton GL, El-Noueam KI. MR evaluation of subscapularis tears. J Comput Assist Tomogr. 1999;23(5):713-17.  Adams CR, Schoolfield JD, Burkhart SS. Accuracy of preoperative magnetic resonance imaging in predicting a subscapularis tendon tear based on arthroscopy. Arthroscopy. 2010;26(11):1427-33.Adams CR, Brady PC, Koo SS, Narbona P, Arrigoni P, Karnes GJ et al. A systematic approach for diagnosing subscapularis tendon tears with preoperative magnetic resonance imaging scans. Arthroscopy. 2012; 28(11):1592-600.Pfirrmann CWA, Zanetti M, Weishaupt D, Gerber C, Hodler J. Subscapularis tendon tears: Detection and grading at MR ar- thrography. Radiology. 1999; 213:709-714.Yoon JP, Chung SW, Kim SH, Oh JH. Diagnostic value of four clinical tests for the evaluation of subscapularis integrity. J Shoulder Elbow Surg. 2013;22(9):1186-92.Beltran J. The use of magnetic resonance imaging about the shoulder. J Shoulder Elbow Surg. 1992; 1(6):321-33.Houtz CG, Schwartzberg RS, Barry JA, Reuss BL, Papa L. Shoulder MRI accuracy in the community setting. J Shoulder Elbow Surg. 2011; 20(4):537-42.Burks RT, Crim J, Brown N, Fink B, Greis PE. A prospective randomized clinical trial comparing arthroscopic single- and double-row rotator cuff repair: magnetic resonance imaging and early clinical evaluation. Am J Sports Med. 2009;37(4):674-82. Gyftopoulos S, O' Donnell J, Shah NP, Goss J, Babb J, Recht MP. Correlation of MRI with arthroscopy for the evaluation of the subscapularis tendon: a musculoskeletal division’s experience. Skeletal Radiol. 2013;42(9):1269-75.Pfirrmann CW1, Zanetti M, Weishaupt D, Gerber C, Hodler J. Subscapularis tendon tears: detection and grading at MR arthrography. Radiology. 1999;213(3):709-14.Spencer EE Jr, Dunn WR, Wright RW, Wolf BR, Spindler KP, McCarty E et al. Interobserver agreement in the classification of rotator cuff tears using magnetic resonance imaging. Am J Sports Med. 2008;36(1):99-103.Toussaint B, Barth J, Charousset C, Godeneche A, Joudet T, Lefebvre Y et al. New endoscopic classification for subscapularis lesions. Orthop Traumatol Surg Res. 2012;98(8 Suppl):S186-92.Lafosse L, Jost B, Reiland Y, Audebert S, Tousaint B, Gobezie R. Structural integrity and clinical outcomes after arthroscopic repair of isolated subescapularis tears. J Bone Joint Surg Am. 2007;89(6):1184-93.Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-74.Balich SM, Sheley RC, Brown TR, Sauser DD, Quinn SF. MR imaging of the rotator cuff tendon: interobserver agreement and analysis of interpretive errors. Radiology. 1997; 204(1):191-94.Robertson PL, Schweitzer ME, Mitchell DG, Schlesinger F, Epstein RE, Frieman BG et al. Rotator cuff disor- ders: interobserver and intraobserver variation in diagnosis with MR imaging. Radiology. 1995;194(3):831-35.Singson RD, Hoang T, Dan S, Friedman M. MR evaluation of rotator cuff pathology using T2-weighted fast spin-echo technique with and without fat suppression. AJR Am J Roentgenol. 1996; 166:1061-65.Szymanski C1, Staquet V, Deladerrière JY, Vervoort T, Audebert S, Maynou C. Reproducibility and reliability of subscapularis tendon assessment using CT-arthrography. Orthop Traumatol Surg Res. 2013;99(1):2-9.

Download Full-text