title: Repair of tears of the subscapularis.
abstract: BACKGROUND
  Rotator cuff tears involving the subscapularis are less common than those involving the superior aspect of the rotator cuff. The purpose of the present study was to report the results of repair of isolated tears of the subscapularis.
  
  
  METHODS
  The records on eighty-four shoulders that had undergone open repair of the subscapularis tendon were reviewed. The mean age of the patients at the time of surgery was 53.2 years. The mean interval from the onset of symptoms to the time of surgery was 12.5 months. Fifty-seven tears were traumatic, and twenty-seven were degenerative. Twenty-three tears involved the superior one-third of the subscapularis tendon, forty-one tears involved the superior two-thirds, and twenty tears were complete. Fifty-four shoulders had a dislocation or subluxation of the long head of the biceps tendon, and ten shoulders had a rupture of the long head of the biceps tendon. Forty-eight shoulders underwent concomitant biceps tenodesis, thirteen shoulders underwent concomitant biceps tenotomy, and four shoulders underwent concomitant recentering of the biceps. Patients were evaluated clinically and radiographically at a mean of forty-five months (range, twenty-four to 132 months) postoperatively.
  
  
  RESULTS
  The mean Constant score increased from 55.0 points preoperatively to 79.5 points postoperatively. Seventy-five patients were satisfied or very satisfied with the result. Preoperatively, four shoulders had mild glenohumeral arthritis. Postoperatively, twenty-five shoulders had mild glenohumeral arthritis and two shoulders had moderate glenohumeral arthritis. Tenodesis or tenotomy of the biceps tendon at the time of subscapularis repair was associated with improved subjective and objective results, independent of the preoperative condition of the biceps tendon.
  
  
  CONCLUSIONS
  Repair of isolated subscapularis tears yields acceptable improvement in shoulder function in selected patients. Additionally, the results of the present study support routine tenodesis or tenotomy of the long head of the biceps tendon at the time of subscapularis repair.
authors.affiliation: Fondren Orthopedic Group, 7401 South Main Street, Houston, TX 77030, USA. bemd@fondren.com
authors.forename: T Bradley
authors.initials: TB
authors.lastname: Edwards
authors.forename: Gilles
authors.initials: G
authors.lastname: Walch
authors.forename: François
authors.initials: F
authors.lastname: Sirveaux
authors.forename: Daniel
authors.initials: D
authors.lastname: Molé
authors.forename: Laurent
authors.initials: L
authors.lastname: Nové-Josserand
authors.forename: Aziz
authors.initials: A
authors.lastname: Boulahia
authors.forename: Lionel
authors.initials: L
authors.lastname: Neyton
authors.forename: Istvan
authors.initials: I
authors.lastname: Szabo
authors.forename: Bruce
authors.initials: B
authors.lastname: Lindgren
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome