[Translated article] Analysis of the results and adverse factors of arthroscopic repair of degenerative subscapular lesions

A Cuéllar; A Cuéllar; R Seijas; M E Barra; R Cuéllar

doi:10.1016/j.recot.2022.07.001

[Translated article] Analysis of the results and adverse factors of arthroscopic repair of degenerative subscapular lesions

Rev Esp Cir Ortop Traumatol. 2022 Sep-Oct;66(5):T319-T327. doi: 10.1016/j.recot.2022.07.001. Epub 2022 Jul 14.

[Article in English, Spanish]

Authors

A Cuéllar¹, A Cuéllar², R Seijas³, M E Barra⁴, R Cuéllar²

Affiliations

¹ Policlinica Gipuzkoa Quirón-Salud, Donostia-San Sebastián, Spain. Electronic address: asier_cuellar@hotmail.com.
² Policlinica Gipuzkoa Quirón-Salud, Donostia-San Sebastián, Spain.
³ Hospital Quirón-Salud, Barcelona, Spain.
⁴ Departamento de Fisioterapia de la Universidad Internacional de Cataluña, Sant Cugat del Vallés, Barcelona, Spain.

PMID: 35843556
DOI: 10.1016/j.recot.2022.07.001

Abstract

Objective: To carry out a review of degenerative subscapularis ruptures (SSC) after their arthroscopic repair and to evaluate whether the results are comparable in terms of pain and function to those of younger patients with traumatic ruptures.

Methods: The data of 80 SSC tears of the 660 rotator cuff tears operated on by the same team of surgeons from June 2008 to June 2018 were retrospectively reviewed. The clinical data of the surgical indications were collected: age, gender, laterality, intervention delay, associated pathologies, location of pain, value of the Visual Analogue Scale (VAS) and the Constant-Murley test (CMT); surgical data were also collected: type and size of lesion, associated biceps injury and associated surgical procedure, coracoid stenosis and associated surgical procedure, number and type of anchors used. A statistical study was performed with multiple linear regression test, parametric tests (Student's t or ANOVA) and non-parametric tests.

Results: Of 80 patients, 36 were women (45%) and 44, men (55%); mean age 61 years (range 47-81); mean delay of surgery 3.5 months (range 1-6); right shoulder affected in 46 cases (57.5%), left in 34 (42.5%); 22 (27.5%) were isolated lesions, 58 (72.5%) were associated with supraspinatus rupture (SE). The mean improvement was 5.0 points in terms of the VAS and 39.9 points on average in the CMT. New breakage rate, 1.25%. Adverse factors: size of the tear, delay in intervention, women. Patients with type I-B rupture have a better overall result in the CMT than types I-A and III. The longer the delay, the worse results are observed, both for the VAS and the CMT. Women present worse and statistically significant results both in the VAS (p 0.00) and in the CMT (p 0.01).

Conclusions: Excellent and good results have been obtained in this group of patients, but there are adverse factors such as the size of the tear, the duration of the symptoms and the association of other pathologies, especially in women.

Keywords: Arthroscopic repair; Hombro; Lesiones del manguito rotador; Lesiones del subescapular; Pronóstico lesiones subescapular; Reparación por artroscopia; Rotator cuff injuries; Shoulder; Subscapular lesions prognosis; Subscapularis lesions.