title: Arthroscopic repair of a significant (>50%) partial-thickness subscapularis tear concomitant with a full-thickness supraspinatus tear: technical considerations for subscapularis repair (transtendon technique versus tear completion).
abstract: BACKGROUND
  The purpose of this study was to compare clinical outcomes and structural integrity of arthroscopic repair by either transtendon repair or tear completion for a significant (>50%) partial-thickness articular-side subscapularis tear associated with a full-thickness supraspinatus tear.
  
  
  METHODS
  The study population comprised 109 patients who underwent arthroscopic repair for partial-thickness subscapularis tears associated with full-thickness supraspinatus tears with either a transtendon technique (81 patients, group T) or tear completion (28 patients, group C). Pain on a visual analog scale; the Subjective Shoulder Value; the American Shoulder and Elbow Surgeons score; and the University of California, Los Angeles shoulder score were used to compare clinical outcomes between the 2 groups. At 6 months after surgery, magnetic resonance arthrography or computed tomographic arthrography was performed to assess structural integrity.
  
  
  RESULTS
  At the 2-year follow-up, there were no significant differences in functional outcomes between groups. In group T, external rotation was reduced significantly from 55° to 51° (P < .001). The subscapularis and overall retear rates were 8% and 19%, respectively, in group T and 12% and 23%, respectively, in group C. There were no significant differences in retear rates between groups.
  
  
  CONCLUSIONS
  Arthroscopic repair of partial-thickness subscapularis tears associated with full-thickness supraspinatus tears using either the transtendon technique or tear completion resulted in significant functional improvements in both groups except for postoperative external rotation in group T, and there were no significant differences between groups. The retear rates were also not significantly different between groups. However, after subscapularis repair using the transtendon technique, some patients may have decreased external rotation.
authors.affiliation: Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sung-Jae
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Min
authors.initials: M
authors.lastname: Jung
authors.affiliation: Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jae-Hoo
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jae-Han
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: min1201@hanmail.net.
authors.forename: Yong-Min
authors.initials: YM
authors.lastname: Chun
mesh_terms: D000368:Aged; D001175:Arthrography; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D012399:Rotation; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000601:surgery; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D013708:Tendon Injuries / Q000601:surgery*; D014056:Tomography, X-Ray; D016896:Treatment Outcome
keywords: Shoulder; arthroscopy; repair; rotator cuff tear; subscapularis