Function of subscapularis after surgical treatment for recurrent instability of the shoulder using a bone-block procedure.
We compared the long-term function of subscapularis after the Latarjet procedure using two surgical approaches. We treated 102 patients (106 shoulders) with a mean age of 26.8 years (15 to 51) with involuntary unidirectional recurrent instability. The operation was carried out through an L-shaped incision with trans-section of the upper two-thirds of the muscle in 69 cases and with a subscapularis split in 37. All clinical results were assessed by the Rowe and the Duplay scores and the function of subscapularis by evaluating the distance and strength at the lift-off position. Bilateral CT was performed in 77 patients for assessment of fatty degeneration. The mean follow-up was 7.5 years (2 to 15) and 18% of cases were lost to follow-up. The mean Duplay score was 82 of 100 for the L-shaped incision group and 90 of 100 for those with a subscapularis split (p = 0.02). The mean fatty degeneration score was 1.18 after an L-shaped incision compared with 0.12 after subscapularis split (p = 0.001). The subscapularis split approach is therefore recommended.
Maynou
C
C
Department of Orthopaedic Surgery, University Hospital of Lille, 2 Avenue Oscar Lambret, 59000 Lille, France. c-maynou@chru-lille.fr
Cassagnaud
X
X
Mestdagh
H
H
D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D009133:Muscular Atrophy / Q000000981:diagnostic imaging / Q000209:etiology; D019637:Orthopedic Procedures / Q000379:methods; D011184:Postoperative Period; D016059:Range of Motion, Articular; D012008:Recurrence; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome