Arthroscopic debridement in the treatment of patients with isolated tears of the subscapularis.
OBJECTIVE
To evaluate the treatment of properly selected patients with isolated subscapularis tears by arthroscopic debridement and release of the long head of the biceps.


METHODS
Eleven shoulders that had undergone arthroscopic debridement in the treatment of subscapularis tears were reviewed. In all patients, 3 months of appropriate nonoperative management had been unsuccessful. Patients were selected for arthroscopic debridement if the tear was thought to be irreparable, or if the patient was older and unwilling to participate in the rehabilitation required after repair had been completed. Mean age at surgery was 64 years. The mean time interval from onset of symptoms to surgery was 11 months. Seven tears were traumatic, and 4 were degenerative. Four tears involved the superior third of the subscapularis tendon, 2 involved the superior two thirds of the subscapularis tendon, and 5 were complete tears. Nine shoulders also had dislocation or subluxation of the long head of the biceps tendon; these patients underwent concomitant biceps tenotomy. Patients were evaluated clinically and radiographically at a mean 34-month follow-up (range, 24 to 48 months).


RESULTS
The mean Constant score increased from 49 points preoperatively to 80 points postoperatively (P < .0001). Nine patients were satisfied or very satisfied with the results. Preoperatively, 2 patients had mild glenohumeral arthritis. Postoperatively, radiographs demonstrated no progression of arthritis and no new-onset arthritis in these 2 patients.


CONCLUSIONS
The combination of arthroscopic debridement and biceps tenotomy in the treatment of subscapularis tears with biceps disease in selected patients yields good objective improvement and a high degree of patient satisfaction.


METHODS
Level IV, therapeutic case series.
Edwards
T Bradley
TB
Fondren Orthopedic Group, Houston, Texas 77030-4509, USA. bemd@fondren.com
Walch
Gilles
G
Nové-Josserand
Laurent
L
Boulahia
Aziz
A
Neyton
Lionel
L
O'Connor
Daniel P
DP
Williams
Matthew D
MD
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D017060:Patient Satisfaction; D011182:Postoperative Care; D011859:Radiography; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome