title: [Anterosuperior rotator cuff tears: rupture configurations and results after arthroscopic therapy - a prospective study].
abstract: BACKGROUND
  Subscapularis (SSC) tendon tears seem to regularly occur combined with lesions of the supraspinatus (SSP) and long biceps (LBS) tendons. The aim of this study was to evaluate the rupture configurations and results after arthroscopic treatment of anterosuperior rotator cuff tears.
  
  
  METHODS
  A total of 65 consecutively treated patients [20 female, 45 male, median age 59 (23-80) years] with anterior and anterosuperior rotator cuff tears were examined prospectively. Rupture configurations were evaluated intraoperatively and subjective parameters, clinical function and Constant-Murley score (CMS) were assessed 12 months postoperatively.
  
  
  RESULTS
  The SSC tears were isolated in 34 % and combined lesions of SSC and SSP were found in 66 % of patients. Additionally, LBS participation was observed in 65 % of patients and 12 (18%) patients had further concomitant lesions. Clinical function improved significantly and the age and gender-related CMS averaged 89.3 % 12 months postoperatively. Reconstructive treatment of concomitant lesions had a negative influence on outcome. Tenotomy of LBS led to better results than tenodesis. All patients would choose arthroscopic treatment again having knowledge of the postoperative result.
  
  
  CONCLUSIONS
  Due to convincing short-term clinical results and advantages of minimally invasive surgery, arthroscopic treatment of anterior and anterosuperior rotator cuff tears has become prevalent. Treatment of concomitant LBS tendon pathology seems to play an important role in most patients. Further development of refixation techniques and better means of visualization will increase the trend towards arthroscopic treatment of anterosuperior rotator cuff tears in the future.
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH, Humboldtstraße 5, 30169, Hannover, Deutschland.
authors.forename: J C
authors.initials: JC
authors.lastname: Katthagen
authors.forename: T
authors.initials: T
authors.lastname: Müller
authors.forename: G
authors.initials: G
authors.lastname: Jensen
authors.forename: C
authors.initials: C
authors.lastname: Voigt
authors.forename: H
authors.initials: H
authors.lastname: Lill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D018570:Risk Assessment; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000175:diagnosis / Q000453:epidemiology; D013708:Tendon Injuries / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult