Floating Subscapularis Tear: A Variation of the Partial Subscapularis Tear

A variation of subscapularis tear has been identified, named floating subscapularis, where the tendon is completely detached from the lesser tuberosity but is continuous with the tissue covering the bicipital groove. An accurate diagnosis can be made using arthroscopic observation with passive external and internal rotation of the affected shoulder, which shows mismatched movement between the humerus and the subscapularis tendon. The purpose of this study is to examine the prevalence of this particular tear pattern. Clinical records during the study period (from January 2011 to December 2017) were retrospectively examined. Overall, 1295 arthroscopic rotator cuff repair procedures were performed. Among these, the subscapularis tendon was repaired in 448 cases, and 27 cases were diagnosed as floating subscapularis. The prevalence of floating subscapularis was 6% in the subscapularis repair population. This particular tear pattern has not previously been described and it seems to be ignored. The floating subscapularis is thought to be the tear of the deep layer preserving the superficial layer connected to the greater tuberosity by fibrous extension of the soft tissue covering the bicipital groove.

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Arthroscopic Subscapularis Tendon Repair Using the Mason-Allen Technique

Zeitschrift für Orthopädie und Unfallchirurgie ◽

10.1055/a-1387-8079 ◽

2021 ◽

Author(s):

Junqi Huang ◽

Jiajia Cheng ◽

Shitian Tang ◽

Bo Shi ◽

Gang Liu ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Tendon Repair ◽

Shoulder Function ◽

Arthroscopic Rotator Cuff Repair ◽

Subscapularis Tendon ◽

Function Recovery ◽

The Mean ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

Abstract Background Arthroscopic rotator cuff repair has recently been popularized for treating tears. In a biomechanical trial, the Mason-Allen stitch improved the fixation quality of poorly vascularized tendons. The use of this technique involving the subscapularis tendon remains rare. The aim of this study was to evaluate the clinical outcomes of Mason-Allen technique repaired subscapularis tendons. Methods A retrospective research of collected data from 98 patients with subscapularis tears who had undergone arthroscopic repair between May 2015 and December 2018. There were 75 males and 23 females. The mean age was 56.4 ± 9.6 years and the mean follow-up was 12.5 ± 4.0 months. The visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and Constant-Murley score were used to analyze shoulder function. An MRI was performed to assess the integrity of the repair. Results Patients had significantly less pain and a better active range of motion compared with preoperative levels. VAS improved significantly from a preoperative mean of 3.42 to a postoperative mean of 1.91. ASES increased significantly from the preoperative mean of 43.6 to the postoperative mean of 74.5. Seven cases suffered from retears, which were confirmed by an MRI examination. Conclusion Arthroscopic rotator cuff repair with the Mason-Allen method resulted in a decreased level of pain and satisfied function recovery.

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EFFECT OF SUBSCAPULARIS TEARS ON FUNCTIONAL SCORES OF PATIENTS UNDERGOING ROTATOR CUFF REPAIR

Acta Ortopédica Brasileira ◽

10.1590/1413-785220192702214524 ◽

2019 ◽

Vol 27 (2) ◽

pp. 116-119 ◽

Cited By ~ 1

Author(s):

Eduardo Angeli Malavolta ◽

Verônica Yulin Prieto Chang ◽

Marcello TraballiBozzi Pinto de Castro ◽

Fernando Brandao Andrade-Silva ◽

Jorge Henrique Assunção ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff Repair ◽

Subscapularis Tendon ◽

Full Thickness ◽

Functional Scores ◽

Tendon Tears ◽

Arthroscopic Rotator Cuff ◽

Upper Third ◽

Cuff Repair

ABSTRACT Objective: To evaluate the influence of partial- and full-thickness upper third subscapularis tendon tears on the functional scores of patients undergoing arthroscopic rotator cuff repair. Methods: Patients who underwent arthroscopic rotator cuff repair were divided into three groups according to the subscapularis tendon condition: intact, partial-thickness tear, or full-thickness upper third tear. Functional scores were compared among groups. Second, the influence of biceps and infraspinatus tears on the scores was tested using multivariate regression analysis. Results: We evaluated 307 shoulders in 297 patients. Full-thickness upper third subscapularis tears presented significantly worse scores than intact tendons. Partial-thickness tears had scores that did not differ significantly from those of the other groups. Patients with full-thickness upper third tears presented a greater rate of injured and unstable biceps tendons. The multivariate analysis showed that biceps and infraspinatus tendon tears did not influence the scores or the intergroup comparison. Conclusion: Full-thickness upper third subscapularis tendon tears presented worse functional scores than intact subscapularis tendons among patients undergoing posterosuperior rotator cuff repair. Patients with full-thickness subscapularis tears were more likely to suffer biceps tears, but this fact did not influence functional scores. Level of Evidence I; Clinical randomized trial

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Effectiveness of measuring tension during arthroscopic rotator cuff repair

Journal of Experimental Orthopaedics ◽

10.1186/s40634-021-00341-2 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Shin Yokoya ◽

Yoshihiro Nakamura ◽

Yohei Harada ◽

Hiroshi Negi ◽

Ryosuke Matsushita ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Multivariate Regression ◽

Subscapularis Tendon ◽

Study Group ◽

Regression Analyses ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair ◽

Tendon Retraction ◽

Infraspinatus Tendon

Abstract Purpose Arthroscopic rotator cuff repair (ARCR) for relatively small rotator cuff tears (RCTs) has shown promising results; however, such surgery for larger tears often results in failure and poor clinical outcomes. One cause of failure is over-tension at the repair site that will be covered with the tendon stump. Reports on the clinical outcomes using ARCR with tension ≤ 30 N are lacking. This study aimed to evaluate ARCR outcomes and failure rates using less tension (30 N) and to assess the prognostic factors for failure. Methods Our study group comprised of 118 patients who underwent ARCR for full-thickness RCTs with full tendon stump coverage of the footprint with a tension of ≤ 30 N, measured using a tension meter; no additional procedures, such as margin convergence or footprint medialisation, were performed. The failure rate was calculated, and the prognostic factor for failure was assessed using multivariate regression analyses. Results There were seven cases of failure in the study group. Postoperatively, flexion and internal rotation ranges of motion, acromiohumeral interval, muscle strength, and clinical results improved significantly. Using multivariate regression analyses, intraoperative concomitant subscapularis tendon lesion and pre-operative infraspinatus tendon retraction, assessed using radial-sequence magnetic resonance imaging, were significantly correlated with post-ARCR failure using less tension (p = 0.030 and p = 0.031, respectively). Conclusion ARCR is likely to succeed for RCTs that can be extracted using tension ≤ 30 N. However, cases with more severe subscapularis tendon lesions and those with high infraspinatus tendon retraction may show surgical failure. Level of evidence LEVEL IV Retrospective case series

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