title: Repair versus shaving of partial-thickness articular-sided tears of the upper subscapularis tendon. A prospective randomized controlled trial.
abstract: OBJECTIVE
  the purpose of this study was to evaluate whether treating partial-thickness articular-sided tears of the upper subscapularis (SSC) tendon with a dedicated suture anchor would result in an internal rotation strength improvement compared with simple shaving of the SSC tendon and footprint.
  
  
  METHODS
  twenty-six patients with a limited SSC tendon tear (equal or inferior to the most superior centimeter) in association with a posterosuperior cuff lesion were prospectively randomized to two treatments: repair with a dedicated suture anchor versus shaving of the tendon and footprint. The patients also underwent long head of the biceps (LHB) treatment and posterosuperior cuff tear repair. In each patient the following parameters were measured both preoperatively and at a minimum follow-up of 2.5 years: strength in internal rotation in the bear-hug testing position (using a digital tensiometer), DASH score and Constant scores. MRI assessment of tendon healing was performed at the final follow-up.
  
  
  RESULTS
  twenty of the 26 patients (76%) were reviewed after a mean follow-up time of 42 months: 11 patients had undergone SSC tendon repair and nine simple shaving. At final follow-up no significant differences were found between the repaired and shaving group in strength in internal rotation (9.5 ± 3.8 kg versus 10.3±5.4 kg; p=0.7). The DASH score and Constant score also failed to show significant differences between the two groups. Furthermore, no significant difference in SSC tendon healing rate was observed on MRI evaluation.
  
  
  CONCLUSIONS
  partial-thickness articular-sided tear of the upper SSC tendon in association with a posterosuperior rotator cuff repair and LHB treatment, when limited to the superior centimeter of the SSC tendon, shows a comparable performance in terms of strength in internal rotation either after simple shaving or a tendon-to-bone repair.
  
  
  METHODS
  Level II, prospective comparative study.
authors.affiliation: Dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano, Italy; UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Randelli
authors.affiliation: UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Arrigoni
authors.affiliation: UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Aliprandi
authors.affiliation: UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Sdao
authors.affiliation: UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Ragone
authors.affiliation: UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: D'Ambrosi
authors.affiliation: UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Randelli
authors.affiliation: Dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano, Italy; UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cabitza
authors.affiliation: Dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano, Italy; UO Ortopedia II, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Banfi
keywords: MRI tendon healing; arthroscopic cuff repair; shaving; subscapularis; suture anchor