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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2018

01-01-2018 | Shoulder

Concomitant coracoplasty during arthroscopic subscapularis repair does not yield better clinical outcomes and structural integrity

Authors: Sung-Jae Kim, Yun-Rak Choi, Min Jung, Yeo-Kwon Yoon, Yong-Min Chun

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2018

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Abstract

Purpose

Few studies have examined whether concomitant coracoplasty is necessary to improve clinical and radiological outcomes after arthroscopic subscapularis repair. The purpose of this study was to compare clinical outcomes and structural integrity after arthroscopic repair of isolated subscapularis full-thickness tear, either with or without concomitant coracoplasty.

Methods

This study included 62 patients who underwent arthroscopic subscapularis repair either with coracoplasty (Group A, 35 patients) or without coracoplasty (Group B, 27 patients). Preoperative and postoperative visual analog scale pain scores, subjective shoulder values, University of California at Los Angeles shoulder scores, American Shoulder and Elbow Surgeon scores, subscapularis strength, and shoulder active range of motion (ROM) were assessed. Postoperative magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was performed 6 months postoperatively for structural integrity assessment.

Results

At 2-year follow-up, all functional scores and ROM improved significantly in both groups compared with preoperative values (p < 0.001). However, none of these values differed significantly between groups. On follow-up MRA or CTA images, although postoperative coracohumeral distance was significantly greater in Group A (8.4 mm ± 2.3 mm versus 7.0 mm ± 2.0 mm) (p = 0.018), the re-tear rates were not significantly different between groups (5/35 (14%) in Group A and 4/27 (15%) in Group B).

Conclusions

For isolated subscapularis full-thickness tears, concomitant coracoplasty with arthroscopic repair did not produce better clinical outcomes or structural integrity than repair without coracoplasty. This suggests that concomitant coracoplasty may not be imperative during arthroscopic repair of isolated subscapularis full-thickness tears.

Level of evidence

III.
Literature
1.
Bartl C, Salzmann GM, Seppel G, Eichhorn S, Holzapfel K, Wortler K, Imhoff AB (2011) Subscapularis function and structural integrity after arthroscopic repair of isolated subscapularis tears. Am J Sports Med 39(6):1255–1262CrossRefPubMed
2.
Bartl C, Scheibel M, Magosch P, Lichtenberg S, Habermeyer P (2011) Open repair of isolated traumatic subscapularis tendon tears. Am J Sports Med 39(3):490–496CrossRefPubMed
3.
Bennett WF (2003) Arthroscopic repair of anterosuperior (supraspinatus/subscapularis) rotator cuff tears: a prospective cohort with 2- to 4-year follow-up. Classification of Biceps Subluxation/Instability. Arthroscopy 19(1):21–33CrossRefPubMed
4.
Gartsman GM, O’Connor DP (2004) Arthroscopic rotator cuff repair with and without arthroscopic subacromial decompression: a prospective, randomized study of one-year outcomes. J Shoulder Elbow Surg 13(4):424–426CrossRefPubMed
5.
Gerber C, Fuchs B, Hodler J (2000) The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am 82(4):505–515CrossRefPubMed
6.
Gerber C, Terrier F, Ganz R (1985) The role of the coracoid process in the chronic impingement syndrome. J Bone Joint Surg Br 67(5):703–708PubMed
7.
Gerber C, Terrier F, Zehnder R, Ganz R (1987) The subcoracoid space: an anatomic study. Clin Orthop Relat Res 215:132–138
8.
Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures: pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 304:78–83
9.
10.
Hamada K, Fukuda H, Mikasa M, Kobayashi Y (1990) Roentgenographic findings in massive rotator cuff tears: A long-term observation. Clin Orthop Relat Res 254:92–96
11.
Kim SH, Oh I, Park JS, Shin SK, Jeong WK (2005) Intra-articular repair of an isolated partial articular-surface tear of the subscapularis tendon. Am J Sports Med 33(12):1825–1830CrossRefPubMed
12.
Kim SJ, Jung M, Lee JH, Kim C, Chun YM (2014) Arthroscopic repair of anterosuperior rotator cuff tears: in-continuity technique vs disruption of subscapularis-supraspinatus tear margin: comparison of clinical outcomes and structural integrity between the two techniques. J Bone Joint Surg Am 96(24):2056–2061CrossRefPubMed
13.
Kim SJ, Jung M, Lee JH, Park JH, Chun YM (2015) Arthroscopic repair of a significant (>50%) partial-thickness subscapularis tear concomitant with a full-thickness supraspinatus tear: technical considerations for subscapularis repair (transtendon technique versus tear completion). J Shoulder Elbow Surg 24(6):875–881CrossRefPubMed
14.
Kim SJ, Kim SH, Lee SK, Seo JW, Chun YM (2013) Arthroscopic repair of massive contracted rotator cuff tears: aggressive release with anterior and posterior interval slides do not improve cuff healing and integrity. J Bone Joint Surg Am 95(16):1482–1488CrossRefPubMed
15.
Kuntz AF, Raphael I, Dougherty MP, Abboud JA (2014) Arthroscopic subscapularis repair. J Am Acad Orthop Surg 22(2):80–89PubMed
16.
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(6):1184–1193CrossRefPubMed
17.
Lanz U, Fullick R, Bongiorno V, Saintmard B, Campens C, Lafosse L (2013) Arthroscopic repair of large subscapularis tendon tears: 2- to 4-year clinical and radiographic outcomes. Arthroscopy 29(9):1471–1478CrossRefPubMed
18.
Lo IK, Burkhart SS (2003) The etiology and assessment of subscapularis tendon tears: a case for subcoracoid impingement, the roller-wringer effect, and TUFF lesions of the subscapularis. Arthroscopy 19(10):1142–1150CrossRefPubMed
19.
Lo IK, Parten PM, Burkhart SS (2003) Combined subcoracoid and subacromial impingement in association with anterosuperior rotator cuff tears: an arthroscopic approach. Arthroscopy 19(10):1068–1078CrossRefPubMed
20.
MacDonald P, McRae S, Leiter J, Mascarenhas R, Lapner P (2011) Arthroscopic rotator cuff repair with and without acromioplasty in the treatment of full-thickness rotator cuff tears: a multicenter, randomized controlled trial. J Bone Joint Surg Am 93(21):1953–1960CrossRefPubMed
21.
Mascarenhas R, Chalmers PN, Sayegh ET, Bhandari M, Verma NN, Cole BJ, Romeo AA (2014) Is double-row rotator cuff repair clinically superior to single-row rotator cuff repair: a systematic review of overlapping meta-analyses. Arthroscopy 30(9):1156–1165CrossRefPubMed
22.
McElvany MD, McGoldrick E, Gee AO, Neradilek MB, Matsen FA 3rd (2015) Rotator cuff repair: published evidence on factors associated with repair integrity and clinical outcome. Am J Sports Med 43(2):491–500CrossRefPubMed
23.
Milano G, Grasso A, Salvatore M, Zarelli D, Deriu L, Fabbriciani C (2007) Arthroscopic rotator cuff repair with and without subacromial decompression: a prospective randomized study. Arthroscopy 23(1):81–88CrossRefPubMed
24.
Millett PJ, Warth RJ (2014) Posterosuperior rotator cuff tears: classification, pattern recognition, and treatment. J Am Acad Orthop Surg 22(8):521–534CrossRefPubMed
25.
Millett PJ, Warth RJ, Dornan GJ, Lee JT, Spiegl UJ (2014) Clinical and structural outcomes after arthroscopic single-row versus double-row rotator cuff repair: a systematic review and meta-analysis of level I randomized clinical trials. J Shoulder Elbow Surg 23(4):586–597CrossRefPubMed
26.
Nove-Josserand L, Boulahia A, Levigne C, Noel E, Walch G (1999) Coraco-humeral space and rotator cuff tears. Rev Chir Orthop Reparatrice Appar Mot 85(7):677–683PubMed
27.
Nove-Josserand L, Hardy MB, Ogassawara RLN, Carrillon Y, Godeneche A (2012) Clinical and structural results of arthroscopic repair of isolated subscapularis tear. J Bone Joint Surg Am 94(17):e125CrossRefPubMed
28.
Oh JH, Kim SH, Kwak SH, Oh CH, Gong HS (2011) Results of concomitant rotator cuff and SLAP repair are not affected by unhealed SLAP lesion. J Shoulder Elbow Surg 20(1):138–145CrossRefPubMed
29.
Park JY, Lhee SH, Oh KS, Kim NR, Hwang JT (2012) Is arthroscopic coracoplasty necessary in subcoracoid impingement syndrome? Arthroscopy 28(12):1766–1775CrossRefPubMed
30.
Richards DP, Burkhart SS, Campbell SE (2005) Relation between narrowed coracohumeral distance and subscapularis tears. Arthroscopy 21(10):1223–1228CrossRefPubMed
31.
Shin SJ, Oh JH, Chung SW, Song MH (2012) The efficacy of acromioplasty in the arthroscopic repair of small- to medium-sized rotator cuff tears without acromial spur: prospective comparative study. Arthroscopy 28(5):628–635CrossRefPubMed
32.
Tan V, Moore RS Jr, Omarini L, Kneeland JB, Williams GR Jr, Iannotti JP (2002) Magnetic resonance imaging analysis of coracoid morphology and its relation to rotator cuff tears. Am J Orthop (Belle Mead NJ) 31(6):329–333
33.
Warner JJ, Higgins L, Parsons IMT, Dowdy P (2001) Diagnosis and treatment of anterosuperior rotator cuff tears. J Shoulder Elbow Surg 10(1):37–46CrossRefPubMed
Metadata
Title
Concomitant coracoplasty during arthroscopic subscapularis repair does not yield better clinical outcomes and structural integrity
Authors
Sung-Jae Kim
Yun-Rak Choi
Min Jung
Yeo-Kwon Yoon
Yong-Min Chun
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4368-7

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