Arthroscopic repair of isolated subscapularis tears: A prospective cohort with 2- to 4-year follow-up

Abstract

Purpose: The goal of this study was to evaluate the outcomes of the arthroscopic repair of isolated subscapularis tears. Additionally, this study explores details of the clinical diagnosis, magnetic resonance arthrography findings, and surgical repair techniques.

Type of study: A prospective cohort.

Methods: The preoperative and postoperative status of patients with isolated subscapularis tears were analyzed using the Constant Score, American Shoulder and Elbow Society Index (ASES Index), a visual analog pain scale (VAS), a single question of percent function compared with the opposite unaffected extremity, and a single question reflecting satisfaction: "Would you undergo the surgery and the postoperative rehabilitation to achieve the result you have today."

Results: There was a statistically significant difference for all outcome measures from preoperative to postoperative follow-up at 2 to 4 years, except for the objective Constant Score. There were no differences based on gender. Preoperative magnetic resonance arthrography aids in the confirmation of the subscapularis tear.

Conclusions: The arthroscopic repair of the isolated subscapularis tear provides for reliable expectations of improvement in function, particularly the use of the arm behind the back, decreases in pain, decreases in biceps subluxation or instability, and the return of active normal internal rotation. Subjectively, magnetic resonance arthrography is better than magnetic resonance imaging for visualizing the subscapularis tear.