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
. 2023 May;31(5):1970-1977.
doi: 10.1007/s00167-022-07262-2. Epub 2022 Dec 1.

The prevalence, classification, radiological and arthroscopic findings of intratendinous subscapularis tears

Lin Lin  1 , Lihua Zhang  2 , Guoqing Cui  1 , Hui Yan  3
Affiliations

The prevalence, classification, radiological and arthroscopic findings of intratendinous subscapularis tears

Lin Lin et al. Knee Surg Sports Traumatol Arthrosc. 2023 May.

Abstract

Purpose: To investigate the clinical characteristics of intratendinous subscapularis (inSSC) tears.

Methods: Retrospectively, 69 patients with arthroscopically confirmed inSSC tears were identified from 2018 to 2019. Preoperatively and at final follow-up, thorough physical examination was performed and clinical outcomes (American Shoulder and Elbow Surgeons [ASES] score; University of California, Los Angeles [UCLA] score; visual analogue scale [VAS] for pain; and Simple Shoulder Test [SST]) were recorded. Features of pre-operative magnetic resonance image (MRI) such as high signalling within the tendon substance, communication to the bicipital groove and long head of biceps tendon (LHBT) lesions were investigated. Characteristics of arthroscopic view were investigated. Bear-hug and internal rotation resistance test at 90° abduction and external rotation (IRRT90°) test were used to assess the SSC strength.

Results: The mean follow-up was 2.4 (2-3) years. The prevalence of arthroscopically confirmed inSSC tears was 69/675 (10.2%) among arthroscopic rotator cuff repairs. Pre-operative physical examination found positive IRRT90° and bear-hug test in 41/60 (68.3%) and 42/69 (60.8%) patients, respectively. The Cohen kappa coefficient was interpreted to be substantial for the evaluation of all MRI parameters. According to the conditions of LHBT, inSSC tears were classified into 3 types: type I: without LHBT subluxation and tear; type II: with LHBT subluxation or tears and type III: with LHBT dislocation. At final follow-up, mean ASES, UCLA, VAS, and SST scores improved significantly from mean of 50.6 ± 14.7, 19.4 ± 3.07, 6.2 ± 2.0, and 6.1 ± 2.5 to mean of 90.7 ± 9.5, 32.2 ± 1.8, 1.4 ± 1.2 and 9.8 ± 2.2, respectively (P < 0.001). Bilateral symmetric strength was found by bear-hug and IRRT90° test in all patients postoperatively.

Conclusion: Understanding features of pre-operative MRI, physical examination and arthroscopic view is helpful to identify inSSC tears. Arthroscopic repair yielded satisfactory clinical outcomes in patients with inSSC tears.

Level of evidence: Level IV.

Keywords: Arthroscopy; Intratendinous tears; Subscapularis.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Lafosse L, Jost B, Reiland Y, Audebert S, Toussaint B, Gobezie R (2007) Structural integrity and clinical outcomes after arthroscopic repair of isolated subscapularis tears. J Bone Joint Surg Am 89:1184–1193 - DOI - PubMed
    1. Toussaint B, Barth J, Charousset C, Godeneche A, Joudet T, Lefebvre Y et al (2012) New endoscopic classification for subscapularis lesions. Orthop Traumatol Surg Res 98:S186-192 - DOI - PubMed
    1. Yoo JC, Rhee YG, Shin SJ, Park YB, McGarry MH, Jun BJ et al (2015) Subscapularis tendon tear classification based on 3-dimensional anatomic footprint: a cadaveric and prospective clinical observational study. Arthroscopy 31:19–28 - DOI - PubMed
    1. Hasler A, Ker A, Passon T, Tondelli T, Gerber C, Wieser K (2022) Nonoperatively managed small- to medium-sized subscapularis tendon tears: magnetic resonance imaging evaluation with a minimum of 5 years of follow-up. JSES Int 6:84–90 - DOI - PubMed
    1. Lee B, Patel V, Itamura J (2022) Subscapularis Tears: Evolution in Treatment Options. J Am Acad Orthop Surg 30:485–492 - DOI - PubMed

LinkOut - more resources