Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2023

Open Access 01-04-2023 | Subscapularis Tendon Tears | SHOULDER

Arthroscopic approach does not yield better results than open surgery after subscapularis repair: a systematic review

Authors: Vito Gaetano Rinaldi, Matteo La Verde, Federico Coliva, Eugenio Cammisa, Giada Lullini, Silvio Caravelli, Massimiliano Mosca, Stefano Zaffagnini, Giulio Maria Marcheggiani Muccioli

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2023

Login to get access

Abstract

Purpose

This study aimed to compare the long-term outcomes of arthroscopic versus mini-open repair in patients with isolated subscapularis tendon tears.

Methods

Google Scholar, PubMed, and Embase databases were searched for studies evaluating isolated subscapularis tears subsequently treated by arthroscopic or mini-open repair. The inclusion criteria were clinical studies reporting isolated subscapularis lesions treated by arthroscopic or mini-open repair, a minimum follow-up of 12 months, and clinical and functional outcomes reported in the study results. Articles not reporting functional outcomes or studies that reported results for anterosuperior rotator cuff tears without a separate analysis of subscapularis tendon tears were excluded. Studies older than 20 years and studies with a minimum follow-up of less than 12 months were also excluded.

Results

A total of 12 studies met the inclusion criteria; 8 papers were included in the arthroscopic repair group, and 6 were included in the mini-open repair group (2 studies reported results for both techniques). The mean age reported was 49.3 years, and 85.1% of patients were male. The dominant limb was involved in 77.6% of the patients, and a traumatic onset of symptoms was verified in 76.3%. The mean time to surgery was 9.6 months. The Constant–Murley score showed positive results for the arthroscopic and mini-open groups, with mean postoperative values of 84.6 and 82.1, respectively. Promising results were also observed for pain, with a mean of 13.2 (out of 15) points for the arthroscopic group and 11.7 for the mini-open group. The long head of the biceps was involved in 78% of the patients, and LHB tenodesis or tenotomy were the most common concomitant procedures performed.

Conclusions

There was no significant difference in clinical and functional outcomes between open and arthroscopic repair. Moreover, the same complication rates were reported in both treatments, but arthroscopic repair led to less postoperative pain.

Level of evidence

IV.
Literature
1.
Ahmad ZY, Diaz LE, Roemer FW, Goud A, Guermazi A (2022) Imaging review of subscapularis tendon and rotator interval pathology. Radiol Res Pract 2022:4009829PubMedPubMedCentral
2.
Almeheyawi RN, Bricca A, Riskowski JL, Barn R, Steultjens M (2021) Foot characteristics and mechanics in individuals with knee osteoarthritis: systematic review and meta-analysis. J Foot Ankle Res 14:24CrossRefPubMedPubMedCentral
3.
Amstutz HC, Sew Hoy AL, Clarke IC (1981) UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res 155:7–20CrossRef
4.
Bartl C, Salzmann GM, Seppel G, Eichhorn S, Holzapfel K, Wörtler K, Imhoff AB (2011) Subscapularis function and structural integrity after arthroscopic repair of isolated subscapularis tears. Am J Sports Med 39:1255–1262CrossRefPubMed
5.
Bartl C, Scheibel M, Magosch P, Lichtenberg S, Habermeyer P (2011) Open repair of isolated traumatic subscapularis tendon tears. Am J Sports Med 39:490–496CrossRefPubMed
6.
Bartl C, Senftl M, Eichhorn S, Holzapfel K, Imhoff A, Salzmann G (2012) Combined tears of the subscapularis and supraspinatus tendon: clinical outcome, rotator cuff strength and structural integrity following open repair. Arch Orthop Trauma Surg 132:41–50CrossRefPubMed
7.
Bennett WF (2003) Arthroscopic repair of isolated subscapularis tears: a prospective cohort with 2- to 4-year follow-up. Arthroscopy 19:131–143CrossRefPubMed
8.
Boileau P, Baqué F, Valerio L, Ahrens P, Chuinard C, Trojani C (2007) Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears. J Bone Jt Surg Am 89:747–757CrossRef
9.
Constant CR (1987) Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164CrossRef
10.
11.
Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, Harris JD (2018) Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. JAAOS Glob Res Rev 2:e088CrossRef
12.
Denard PJ, Jiwani AZ, Lädermann A, Burkhart SS (2012) Long-term outcome of a consecutive series of subscapularis tendon tears repaired arthroscopically. Arthroscopy 28:1587–1591CrossRefPubMed
13.
Edwards TB, Walch G, Sirveaux F (2005) Repair of tears of the subscapularis. J Bone Jt Surg Am 87(4):725–730CrossRef
14.
Elia F, Azoulay V, Lebon J, Faraud A, Bonnevialle N, Mansat P (2017) Clinical and anatomic results of surgical repair of chronic rotator cuff tears at ten-year minimum follow-up. Int Orthop 41:1219–1226CrossRefPubMed
15.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative (2014) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg Lond Engl 12:1495–1499CrossRef
16.
Eriksen MB, Frandsen TF (2018) The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. J Med Libr Assoc JMLA 106:420–431PubMed
17.
Fuchs B, Gilbart MK, Hodler J, Gerber C (2006) Clinical and structural results of open repair of an isolated one-tendon tear of the rotator cuff. J Bone Jt Surg Am 88:309–316CrossRef
18.
Godfrey J, Hamman R, Lowenstein S, Briggs K, Kocher M (2007) Reliability, validity, and responsiveness of the simple shoulder test: psychometric properties by age and injury type. J Shoulder Elbow Surg 16:260–267CrossRefPubMed
19.
Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1995) Fatty infiltration of disrupted rotator cuff muscles. Rev Rhum Engl Ed 62:415–422PubMed
20.
Heikenfeld R, Gigis I, Chytas A, Listringhaus R, Godolias G (2012) Arthroscopic reconstruction of isolated subscapularis tears: clinical results and structural integrity after 24 months. Arthroscopy Relat Surg 28:1805–1811CrossRef
21.
22.
Kreuz PC, Remiger A, Lahm A, Herget G, Gächter A (2005) Comparison of total and partial traumatic tears of the subscapularis tendon. J Bone Joint Surg Br 87-B:348–351CrossRef
23.
Lafosse L, Lanz U, Saintmard B, Campens C (2010) Arthroscopic repair of subscapularis tear: surgical technique and results. Orthop Traumatol Surg Res OTSR 96:S99-108CrossRefPubMed
24.
25.
Mall NA, Chahal J, Heard WM, Bach BR, Bush-Joseph CA, Romeo AA, Verma NN (2012) Outcomes of arthroscopic and open surgical repair of isolated subscapularis tendon tears. Arthroscopy 28:1306–1314CrossRefPubMed
26.
27.
Michener LA, McClure PW, Sennett BJ (2002) American shoulder and elbow surgeons standardized shoulder assessment form, patient self-report section: reliability, validity, and responsiveness. J Shoulder Elbow Surg 11:587–594CrossRefPubMed
28.
Millett PJ, Horan MP, Maland KE, Hawkins RJ (2011) Long-term survivorship and outcomes after surgical repair of full-thickness rotator cuff tears. J Shoulder Elbow Surg 20:591–597CrossRefPubMed
29.
Namdari S, Henn RF, Green A (2008) Traumatic anterosuperior rotator cuff tears: the outcome of open surgical repair. J Bone Jt Surg Am 90:1906–1913CrossRef
30.
Nové-Josserand L, Chauvet T, Baudin F, Godenèche A, Collotte P, Vieira TD, Haritinian E (2021) Subcapularis tendon tear: a structure-based arthroscopic description. Orthop Traumatol Surg Res OTSR 107:102757CrossRefPubMed
31.
Nové-Josserand L, Hardy M-B, Leandro Nunes Ogassawara R, Carrillon Y, Godenèche A (2012) Clinical and structural results of arthroscopic repair of isolated subscapularis tear. J Bone Jt Surg 94:e125CrossRef
32.
Nové-Josserand L, Saffarini M, Hannink G, Carrillon Y (2016) Influence of pre-operative tear size and tendon retraction on repair outcomes for isolated subscapularis tears. Int Orthop 40:2559–2566CrossRefPubMed
33.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https://​doi.​org/​10.​1136/​bmj.​n71CrossRefPubMedPubMedCentral
34.
Smucny M, Shin EC, Zhang AL, Feeley BT, Gajiu T, Hall SL, Ma CB, MOON Shoulder Group (2016) Poor agreement on classification and treatment of subscapularis tendon tears. Arthroscopy 32:246.e1-251.e1CrossRef
35.
Sugaya H, Maeda K, Matsuki K, Moriishi J (2005) Functional and structural outcome after arthroscopic full-thickness rotator cuff repair: single-row versus dual-row fixation. Arthroscopy 21:1307–1316CrossRefPubMed
36.
Szabó I, Boileau P, Walch G (2008) The proximal biceps as a pain generator and results of tenotomy. Sports Med Arthrosc Rev 16:180–186CrossRefPubMed
37.
Toussaint B, Barth J, Charousset C, Godeneche A, Joudet T, Lefebvre Y, Nove-Josserand L, Petroff E, Solignac N, Hardy P, Scymanski C, Maynou C, Thelu C-E, Boileau P, Graveleau N, Audebert S, French Arthroscopy Society (SFA) (2012) New endoscopic classification for subscapularis lesions. Orthop Traumatol Surg Res OTSR 98:S186-192CrossRefPubMed
38.
Warner JJ, Higgins L, Parsons IM, Dowdy P (2001) Diagnosis and treatment of anterosuperior rotator cuff tears. J Shoulder Elbow Surg 10:37–46CrossRefPubMed
39.
Weishaupt D, Zanetti M, Tanner A, Gerber C, Hodler J (1999) Lesions of the reflection pulley of the long biceps tendon. MR arthrographic findings. Invest Radiol 34:463–469CrossRefPubMed
40.
Yoo JC, Rhee YG, Shin SJ, Park YB, McGarry MH, Jun BJ, Lee TQ (2015) Subscapularis tendon tear classification based on 3-dimensional anatomic footprint: a cadaveric and prospective clinical observational study. Arthroscopy 31:19–28CrossRefPubMed
Metadata
Title
Arthroscopic approach does not yield better results than open surgery after subscapularis repair: a systematic review
Authors
Vito Gaetano Rinaldi
Matteo La Verde
Federico Coliva
Eugenio Cammisa
Giada Lullini
Silvio Caravelli
Massimiliano Mosca
Stefano Zaffagnini
Giulio Maria Marcheggiani Muccioli
Publication date
01-04-2023
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-023-07403-1

Other articles of this Issue 7/2023

Knee Surgery, Sports Traumatology, Arthroscopy 7/2023 Go to the issue

SHOULDER

No correlation exists between coracoid tunnel widening and loss of reduction after arthroscopic acromioclavicular fixation using tightrope system

Knee

Allografts as alternative to autografts in primary posterior cruciate ligament reconstruction: a systematic review and meta-analysis

Knee

Meniscal allograft transplantation in discoid meniscus patients achieves good clinical outcomes and superior chondroprotection compared to meniscectomy in the long term

KNEE

Bone–patellar tendon–bone autograft and female sex are associated with the presence of cyclops lesions and syndrome after anterior cruciate ligament reconstruction

KNEE

Accuracy of femoral tunnel positioning in medial patellofemoral ligament reconstruction: anatomic insertion leads to better clinical outcome

KNEE

High prevalence of increased posterior tibial slope in ACL revision surgery demands a patient-specific approach