title: Evaluation of isometric strength and fatty infiltration of the subscapularis in latarjet surgery.
abstract: OBJECTIVE
  To evaluate the function of the subscapularis muscle by means of isometric strength, clinical examination and analysis of fatty infiltration in patients with recurrent anterior dislocation of the shoulder undergoing Latarjet-Patte surgery.
  
  
  METHODS
  38 patients operated from March 2011 to March 2012, with minimum follow-up of two years were evaluated, being 26 males and 12 females, with a mean age of 28.7 years old. Isometric strength was measured using a portable dynamometer and measuring the distance from the back of the hand during the lift-off test. We used the Rowe and Walch-Duplay scores for clinical evaluation. The degree of fatty infiltration of the subscapularis belly was assessed by computed tomography.
  
  
  RESULTS
  The mean scores in the Walch-Duplay and Rowe were 84.7 and 89.4, respectively. The mean distance to the back of the hand was 7.34 cm on the operated side and 8.72 cm on the opposite side (p <0.0001). The mean strength measured in the lift-off test was 0.38 kg lower than on the contralateral side (p = 0.001). There was no fatty infiltration of the subscapularis in 16 patients (42.1%). Sixteen patients (42.1%) were classified as Goutallier grade 1 and six (15.8%) as grade 2. We found that the measured isometric strength decreases with increasing the degree of fatty infiltration (p <0.0001).
  
  
  CONCLUSIONS
  The decrease in subscapularis strength, albeit of low magnitude (0.38 kg), was directly related to the degree of fatty infiltration and worse clinical outcomes. Level of Evidence III, Therapeutic Study - Investigating the Results of Treatment.
authors.affiliation: Universidade Federal de Pernambuco, Recife, PE, Brazil.
authors.forename: Ricardo Barreto Monteiro
authors.initials: RB
authors.lastname: Dos Santos
authors.affiliation: Hospital Miguel Arraes, Recife, PE, Brazil.
authors.forename: Fábio Neumann
authors.initials: FN
authors.lastname: Kauffman
authors.affiliation: Universidade Federal de Pernambuco, Recife, PE, Brazil.
authors.forename: Gabriel Praxedes
authors.initials: GP
authors.lastname: de Lima
authors.affiliation: Universidade Federal de Pernambuco, Recife, PE, Brazil.
authors.forename: Avraham Machado Costa
authors.initials: AM
authors.lastname: Ferreira
authors.affiliation: Universidade Federal de Pernambuco, Recife, PE, Brazil.
authors.forename: Saulo Monteiro
authors.initials: SM
authors.lastname: Dos Santos
authors.affiliation: Universidade Federal de Pernambuco, Recife, PE, Brazil.
authors.forename: José Lamartine de Andrade
authors.initials: JL
authors.lastname: Aguiar
keywords: Muscle strength; Orthopedics; Shoulder dislocation