title: A multicenter study to evaluate subscapularis muscle function using 5:30 o'clock portal for antero-inferior shoulder stabilization.
abstract: BACKGROUND
  The purpose of this study was to compare the outcome after arthroscopic antero-inferior shoulder stabilization with and without using a 5:30 o'clock portal.
  
  
  METHODS
  Sixty-two patients [age (mean ± SD), 28.05 ± 8.25 years] with a mean follow-up of 15.23 ± 5.02 months were included in this study. Thirty-one patients underwent arthroscopic antero-inferior shoulder stabilization using the 5:30 o'clock portal in center A (group I) and were compared to 31 matched patients managed with the 3 o'clock portal in center B (group II). Physical examination, standard shoulder scores, ultrasound assessment and subscapularis strength measurement were used to evaluate postoperative shoulder function.
  
  
  RESULTS
  Good to excellent results were seen in both groups. No significant differences were seen when comparing ASES, Constant and Rowe Score of both groups. Patients of group II achieved a significant higher score in the SST than patients of group I. (p < 0.05) Patients of group I had a significantly lesser loss of passive external rotation in 0° and 90° of abduction. (p = 0.04; p = 0.056) Ultrasound evaluation and strength measurement showed no significant differences in subscapularis muscle integrity or function neither between the involved and uninvolved shoulder nor between both groups.
  
  
  CONCLUSIONS
  Arthroscopic anterior-inferior shoulder stabilization results in excellent clinical results. When considering portal placement, the deep trans-subscapularis portal allows a more precise suture anchor placement at the inferior glenoid rim and capsular shift with a significant improved external rotation but does not negatively affect the subscapularis function in terms of internal rotation strength or structural integrity.
  
  
  METHODS
  III.
authors.affiliation: Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Minzlaff
authors.affiliation: Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany.
authors.forename: Jakob
authors.initials: J
authors.lastname: Ackermann
authors.affiliation: Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany.
authors.forename: Gernot
authors.initials: G
authors.lastname: Seppel
authors.affiliation: Institute of Medical Statistics and Epidemiology, Technische Universitaet Muechnen, Munich, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Haller
authors.affiliation: Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany.
authors.forename: Johannes E
authors.initials: JE
authors.lastname: Plath
authors.affiliation: OCM (Orthopaedic Surgery Munich), Steinerstrasse 6, 81369, Muenchen, Germany.
authors.forename: Ernst
authors.initials: E
authors.lastname: Wiedemann
authors.affiliation: Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany. imhoff@tum.de.|Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universität Muenchen, Ismaningerstr. 22, 81675, Muenchen, Germany. imhoff@tum.de.
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D020679:Arthroscopes; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000502:physiology* / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery*; D053441:Suture Anchors; D055815:Young Adult
keywords: Arthroscopy; Bankart repair; Range of motion; Shoulder stabilization; Strength; Subscapularis