Concomitant coracoplasty during arthroscopic subscapularis repair does not yield better clinical outcomes and structural integrity.
OBJECTIVE
Few studies have examined whether concomitant coracoplasty is necessary to improve clinical and radiological outcomes after arthroscopic subscapularis repair. The purpose of this study was to compare clinical outcomes and structural integrity after arthroscopic repair of isolated subscapularis full-thickness tear, either with or without concomitant coracoplasty.


METHODS
This study included 62 patients who underwent arthroscopic subscapularis repair either with coracoplasty (Group A, 35 patients) or without coracoplasty (Group B, 27 patients). Preoperative and postoperative visual analog scale pain scores, subjective shoulder values, University of California at Los Angeles shoulder scores, American Shoulder and Elbow Surgeon scores, subscapularis strength, and shoulder active range of motion (ROM) were assessed. Postoperative magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was performed 6 months postoperatively for structural integrity assessment.


RESULTS
At 2-year follow-up, all functional scores and ROM improved significantly in both groups compared with preoperative values (p < 0.001). However, none of these values differed significantly between groups. On follow-up MRA or CTA images, although postoperative coracohumeral distance was significantly greater in Group A (8.4 mm ± 2.3 mm versus 7.0 mm ± 2.0 mm) (p = 0.018), the re-tear rates were not significantly different between groups (5/35 (14%) in Group A and 4/27 (15%) in Group B).


CONCLUSIONS
For isolated subscapularis full-thickness tears, concomitant coracoplasty with arthroscopic repair did not produce better clinical outcomes or structural integrity than repair without coracoplasty. This suggests that concomitant coracoplasty may not be imperative during arthroscopic repair of isolated subscapularis full-thickness tears.


METHODS
III.
Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, CPO Box 8044, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Sung-Jae
SJ
Kim
Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, CPO Box 8044, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Yun-Rak
YR
Choi
Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, CPO Box 8044, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Min
M
Jung
Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, CPO Box 8044, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Yeo-Kwon
YK
Yoon
Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, CPO Box 8044, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea. min1201@hanmail.net.
Yong-Min
YM
Chun
D000328:Adult; D000368:Aged; D001182:Arthroscopy; D000070597:Coracoid Process / Q000293:injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D012421:Rupture; D012785:Shoulder Joint / Q000601:surgery
Arthroscopy; Coracoplasty; Repair; Subscapularis tear