CC BY-NC-ND-license · Joints 2015; 03(03): 109-115
DOI: 10.11138/jts/2015.3.3.109
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Repair versus shaving of partial-thickness articular-sided tears of the upper subscapularis tendon. A prospective randomized controlled trial

Pietro Randelli
1   Dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano, Italy
2   UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
,
Paolo Arrigoni
2   UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
,
Alberto Aliprandi
2   UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
,
Silvana Sdao
2   UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
,
Vincenza Ragone
2   UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
,
Riccardo D’Ambrosi
2   UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
,
Filippo Randelli
2   UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
,
Paolo Cabitza
1   Dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano, Italy
2   UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
,
Giuseppe Banfi
1   Dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano, Italy
2   UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
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Publikationsverlauf

Publikationsdatum:
15. September 2017 (online)

Abstract

Purpose:the purpose of this study was to evaluate whether treating partial-thickness articular-sided tears of the upper subscapularis (SSC) tendon with a dedicated suture anchor would result in an internal rotation strength improvement compared with simple shaving of the SSC tendon and footprint.

Methods: twenty-six patients with a limited SSC tendon tear (equal or inferior to the most superior centimeter) in association with a posterosuperior cuff lesion were prospectively randomized to two treatments: repair with a dedicated suture anchor versus shaving of the tendon and footprint. The patients also underwent long head of the biceps (LHB) treatment and posterosuperior cuff tear repair. In each patient the following parameters were measured both preoperatively and at a minimum follow-up of 2.5 years: strength in internal rotation in the bear-hug testing position (using a digital tensiometer), DASH score and Constant scores. MRI assessment of tendon healing was performed at the final follow-up.

Results: twenty of the 26 patients (76%) were reviewed after a mean follow-up time of 42 months: 11 patients had undergone SSC tendon repair and nine simple shaving. At final follow-up no significant differences were found between the repaired and shaving group in strength in internal rotation (9.5 ± 3.8 kg versus 10.3±5.4 kg; p=0.7). the DASH score and Constant score also failed to show significant differences between the two groups. Furthermore, no significant difference in SSC tendon healing rate was observed on MRI evaluation.

Conclusions: partial-thickness articular-sided tear of the upper SSC tendon in association with a posterosuperior rotator cuff repair and LHB treatment, when limited to the superior centimeter of the SSC tendon, shows a comparable performance in terms of strength in internal rotation either after simple shaving or a tendon-to-bone repair.

Level of evidence: Level II, prospective comparative study.