The influence of subscapularis tendon reattachment on range of motion in reversed shoulder arthroplasty: a clinical study

Abstract

Purpose: Reverse shoulder arthroplasty becomes more widely used as a treatment for patients with painful cuff arthropathy. As a part of the deltopectoral approach, the subscapularis tendon, if present, is (partly) detached. There is no consensus on repair of the tendon after placement of the prosthesis. We retrospectively describe the clinical effects of subscapularis tendon reattachment. Our hypothesis was that subscapularis repair has no clinical effects on range of motion and functional outcome scores.

Methods: A retrospective clinical study is performed. An Aequalis reverse shoulder prosthesis (Tornier, Montbonnot, France) was placed in 65 patients with a mean age of 73.8 years (range 47-90). In 40 patients (61.5 %), the quality of the tendon was initially insufficient for repair. The subscapularis was repaired in 25 patients (38.5 %). After a mean follow-up of 36 months with a minimum of 12 months, an ultrasound examination of the subscapularis was performed in patients with a repaired tendon. Range of motion, strength, Constant-Murley and Oxford scores were measured.

Results: On ultrasound examination, 10 (40 %) out of 25 repaired subscapularis tendons were still sufficient. Postoperatively, range of motion, strength, Constant-Murley and Oxford scores did not differ significantly between repair with present tendon, repair with absent tendon or no repair.

Conclusion: In reverse shoulder arthroplasty, no significant differences on range of motion, functional outcome scores or strength were found between subscapularis repair or no repair, whether the tendon healed at follow-up or not.

Keywords: Prosthesis; Reattachment; Repair; Reverse; Shoulder; Subscapularis.