Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;29(1):154-161.
doi: 10.1007/s00167-020-05891-z. Epub 2020 Feb 13.

Anterior rotator cable disruption does not affect outcomes in rotator cuff tear with subscapularis involvement

Tae-Hwan Yoon  1 , Sung-Jae Kim  1 , Yun-Rak Choi  1 , Ju-Cheol Shin  1 , Sager-Holyl Alruwaili  1 , Yong-Min Chun  2
Affiliations

Anterior rotator cable disruption does not affect outcomes in rotator cuff tear with subscapularis involvement

Tae-Hwan Yoon et al. Knee Surg Sports Traumatol Arthrosc. 2021 Jan.

Abstract

Purpose: The purpose of this study was to compare clinical and radiological outcomes after arthroscopic repair of two different rotator cuff tear configurations: anterosuperior rotator cuff tear and rotator cuff tears with subscapularis involvement. It was hypothesized that, although both tear configurations would show significant improvement in clinical outcomes after arthroscopic repair, the rotator cuff tears with subscapularis involvement where the anterior rotator cable maintains its integrity would have better clinical outcomes and structural integrity.

Methods: This study included 226 patients who underwent arthroscopic repair of anterosuperior rotator cuff tears (n = 107, group A) and rotator cuff tears with subscapularis involvement (n = 119, group B). The visual analog scale (VAS) pain score, subjective shoulder value (SSV), American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) shoulder score, and active range of motion (ROM) were assessed. Modified belly press test was performed to assess the strength of the subscapularis muscle. Cuff integrity was evaluated using magnetic resonance arthrography or computed tomographic arthrography at 6 months after operation.

Results: At 3-year follow-up, the VAS score, SSVs, ASES scores, UCLA shoulder scores, active ROM, and modified belly press test showed significant improvement in both groups (p < 0.001). However, these improvements showed no statistical significance between the two groups. On follow-up radiologic evaluations, no significant difference in re-tear rates between group A (25 of 107, 23.4%) and group B (23 of 119, 19.3%) was observed.

Conclusions: The presence of anterior cable involvement of the anterosuperior rotator cuff tear did not affect postoperative clinical outcomes and re-tear rate compared to rotator cuff tears with subscapularis involvement where the anterior cable integrity was maintained, although the anterosuperior rotator cuff tear was associated with more significant preoperative supraspinatus fatty infiltration. Therefore, the present study determined that it would not be necessary to differentiate treatment protocols between these patterns.

Level of evidence: Level III.

Keywords: Anterior cable; Re-tear; Rotator cable; Rotator cuff tear; Subscapularis.

PubMed Disclaimer

References

    1. Araki D, Miller RM, Fujimaki Y, Hoshino Y, Musahl V, Debski RE (2015) Effect of tear location on propagation of isolated supraspinatus tendon tears during increasing levels of cyclic loading. J Bone Joint Surg Am 97:273–278 - DOI
    1. Burkhart SS, Esch JC, Jolson RS (1993) The rotator crescent and rotator cable: an anatomic description of the shoulder's “suspension bridge”. Arthroscopy 9:611–616 - DOI
    1. Cho NS, Moon SC, Hong SJ, Bae SH, Rhee YG (2017) Comparison of clinical and radiological results in the arthroscopic repair of full-thickness rotator cuff tears with and without the anterior attachment of the rotator cable. Am J Sports Med 45:2532–2539 - DOI
    1. Curtis AS, Burbank KM, Tierney JJ, Scheller AD, Curran AR (2006) The insertional footprint of the rotator cuff: an anatomic study. Arthroscopy 22:609.e601 - DOI
    1. Denard PJ, Koo SS, Murena L, Burkhart SS (2012) Pseudoparalysis: the importance of rotator cable integrity. Orthopedics 35:e1353–1357 - DOI

LinkOut - more resources