title: [The isolated subscapularis tendon tear: arthroscopic and open repair].
abstract: OBJECTIVE
  Arthroscopic or open reconstruction of isolated subscapularis tendon tears with the use of suture anchors to restore the glenohumeral function and joint biomechanics.
  
  
  METHODS
  Traumatic full-thickness tears, chronic tears with a functional deficit or decentration of the humerus head, anterosuperior rotator cuff insufficiency, symptomatic reruptures after prior arthroscopic or open surgical procedures.
  
  
  METHODS
  Frozen shoulder, atrophy > grade II (Thomazeau) or fatty infiltration > grade III (Goutallier/Fox) of the muscle, high-grade omarthrosis.
  
  
  METHODS
  Diagnostic arthroscopy and careful tendon release. If the inferior edge of the rupture is reliable visible and the tendon-mobilisation works proper, the repair is performed arthroscopically. The footprint is decorticated lightly and 1-4 suture anchors (depending on the lesion-size) are placed from inferior to superior. Knots are tied starting from caudal in a modified Mason-Allen technique (alternative: single or double mattress stitches) with a slipknot and three half hitches in opposite directions.                 In case of larger tears, a double-row technique for better reconstruction of the trapezoidal footprint is performed. For open reconstruction, a deltopectoral approach is used to reattache the tendon in an analogous fashion.
  
  
  RESULTS
  Arthroscopic or open repair of isolated subscapularis tendon tears (Fox type II-IV) was performed in 35 patients. The Constant score increased significantly after 36 m, with no difference between these two groups. The majority of subscapularis tests were postoperatively negative, 6% in both groups showed a rerupture. A symptomatic period of > 6 m prior to the operation and a high grade atrophy and fatty infiltration of the muscle was correlated with poorer results.
authors.affiliation: Abteilung für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Minzlaff
authors.forename: C
authors.initials: C
authors.lastname: Bartl
authors.forename: A B
authors.initials: AB
authors.lastname: Imhoff
mesh_terms: D001182:Arthroscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000175:diagnosis / Q000601:surgery; D012540:Scapula / Q000601:surgery*; D013708:Tendon Injuries / Q000601:surgery*; D058971:Tenotomy / Q000379:methods*; D016896:Treatment Outcome