title: Influence of pre-operative tear size and tendon retraction on repair outcomes for isolated subscapularis tears.
abstract: The purpose of this study was to investigate the influence of tendon tear size, in terms of length and retraction, on clinical and anatomic outcomes following repair for isolated subscapularis tears.
  
  
  
  The records of 47 consecutive repairs of isolated subscapularis lesions were studied to correlate pre-operative tear characteristics with clinical and radiographic outcomes.
  
  
  
  Forty patients had complete radiographic outcomes at 3.2 ± 1.1 years, of which 36 had complete clinical outcomes at 3.5 ± 0.9 years. Re-tears were observed in five shoulders (12.5 %). Fatty infiltration increased by one grade in 20 shoulders (50 %), and by two grades in four shoulders (10 %). Pre-operative tear size was associated with the post-operative belly-press test (BPT) (p = 0.042) and fatty infiltration (p = 0.051). Pre-operative tendon retraction was associated with post-operative BPT (p < 0.001) and fatty infiltration (p = 0.023).
  
  
  
  Our results do not entirely prove that prognostic factors used for superior and posterior tendon tears apply for the subscapularis. Pre-operative tendon retraction is a better predictor of outcomes than tear size. When tear size and tendon retraction are simultaneously severe, re-tears and poor outcomes are more likely.
authors.affiliation: Centre Orthopédique Santy, Hôpital Privé Jean Mermoz, Ramsay Générale de Santé, 24 Avenue Paul Santy, 69008, Lyon, France. lnovejosserand.md@orthosanty.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Nové-Josserand
authors.affiliation: Alliance Scientifique, 85 rue du Président Edouard Herriot, 69002, Lyon, France.
authors.forename: Mo
authors.initials: M
authors.lastname: Saffarini
authors.affiliation: Orthopaedic Research Laboratory, Radboud University Medical Center, PO Box 9101, 6500HB, Nijmegen, The Netherlands.
authors.forename: Gerjon
authors.initials: G
authors.lastname: Hannink
authors.affiliation: Centre Orthopédique Santy, Hôpital Privé Jean Mermoz, Ramsay Générale de Santé, 24 Avenue Paul Santy, 69008, Lyon, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Carrillon
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D022125:Lacerations; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D013708:Tendon Injuries / Q000601:surgery*
keywords: Arthroscopic repair; Fatty infiltration; Isolated subscapularis tears; Open repair; Rotator cuff; Tear size; Tendon retraction