The Journal of Bone and Joint Surgery (American). 2007;89:2378-2388.
doi:10.2106/JBJS.G.00082
© 2007 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the exams for this article:
 Shoulder/Elbow Test 22: Winter 2008 (publication date February 15, 2008; ex...
Sports Test 13: Winter 2008 (publication date February 15, 2008; expiration...
CME 4: October, November, December 2007 (publication date January 4, 2008; ...
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ide, J.
Right arrow Articles by Mizuta, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ide, J.
Right arrow Articles by Mizuta, H.
Related Collections
Right arrow Shoulder
Right arrow Sports
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?

Arthroscopic Repair of Traumatic Combined Rotator Cuff Tears Involving the Subscapularis Tendon

Junji Ide, MD1, Akinari Tokiyoshi, MD1, Jun Hirose, MD1 and Hiroshi Mizuta, MD1

1 Department of Orthopaedic and Neuro-Musculoskeletal Surgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan. E-mail address for J. Ide: ide{at}kumamoto-u.ac.jp

Investigation performed at the Department of Orthopaedic and Neuro-Musculoskeletal Surgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).

Background: Although the use of arthroscopic repair to treat rotator cuff tears involving the subscapularis has increased, there are few studies on treatment outcomes and repair integrity. We hypothesized that arthroscopic repair of combined rotator cuff tears that include the subscapularis yields successful functional and structural outcomes.

Methods: Our study population consisted of seventeen men and three women (twenty shoulders) whose mean age was 61.7 years. The mean duration of follow-up was 36.1 months, and all patients were followed for at least two years. All had traumatic full-thickness tears of the subscapularis and supraspinatus, and seven had a concomitant infraspinatus tear. The mean time from the injury to the surgery was 2.7 months. An arthroscopic suture-anchor technique was used for the repair. The shoulders were evaluated before and after the procedure with use of the University of California at Los Angeles (UCLA) score, the Japanese Orthopaedic Association (JOA) score, plain radiographs, and magnetic resonance imaging scans.

Results: After arthroscopic repair, the mean UCLA and JOA scores significantly improved from 14.9 and 55.7 points to 31.1 and 91.0 points, respectively (p < 0.0001). According to the JOA rating scale, the outcome was excellent for thirteen patients (65%), good for five (25%), fair for one (5%), and poor for one (5%). Of the twenty patients, seven (35%) had recurrent tears after the surgery; four of them had originally had a three-tendon tear and the other three had had a two-tendon tear. Of these seven patients, one had an excellent outcome; five, a good outcome; and one, a fair outcome. The postoperative mean JOA score was significantly lower for the patients with a failed repair than it was for those with an intact repair (p = 0.0034). The patients with a failed repair also had a significantly higher mean age (68.4 years compared with 58.1 years for those with an intact repair; p = 0.014), and the prevalence of recurrent tears was significantly higher in the patients with severe tendon retraction compared with those with minimal or moderate tendon retraction (p = 0.0191).

Conclusions: Arthroscopic repair with use of the suture anchor technique is a safe and effective procedure for the treatment of combined rotator cuff tears involving the subscapularis tendon; it can alleviate shoulder pain and improve function and the range of motion. The postoperative integrity of the repair correlates with the clinical results. Patient age and the degree of tendon retraction can affect the integrity of the repair.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
S. Namdari, R. F. Henn III, and A. Green
Traumatic Anterosuperior Rotator Cuff Tears: The Outcome of Open Surgical Repair
J. Bone Joint Surg. Am., September 1, 2008; 90(9): 1906 - 1913.
[Abstract] [Full Text] [PDF]