Clinical outcome and structural integrity of all-arthroscopic repair of degenerative subscapularis tendon tears.

Purpose: The purpose of this study was to evaluate the clinical outcome of all-arthroscopic repair of degenerative subscapularis tendon tears and post-operative structural integrity using magnetic resonance imaging with a short-term follow-up.

Methods: Twenty-one patients were treated all-arthroscopically for a full-thickness degenerative subscapularis tendon tear. Median patient age was 55 years (range, 41-69). Median follow-up was 25 months (range, 15-44). Patients were evaluated prior to surgery and at follow-up: active range of motion, VAS pain, Simple Shoulder Test (SST), and the Disabilities of the Arm, Shoulder, and Hand score (DASH). At final follow-up, the Constant-Murley score was evaluated.

Results: Mean active range of motion showed significant post-operative improvement (p < 0.001). VAS pain improved from 8.3 (SD ± 1.3) pre-operatively to 2.7 (SD ± 1.8) post-operatively (<0.001); SST increased from 20 % (SD ± 26) pre-operatively to 83 % (SD ± 27) post-operatively (<0.001); DASH scores improved 67 (SD ± 19) to 18 (SD ± 21) post-operatively (<0.001). Post-operative Constant-Murley score was 79 (SD ± 12). Two patients had failure of the repair on post-operative MRI. Twelve cases (57 %) showed post-operative progression of fatty muscle infiltration.

Conclusion: All-arthroscopic repair is an effective treatment modality for degenerative subscapularis tendon tears with an anterosuperior tear pattern with good clinical results and high patient satisfaction. Although there was a high tendon-to-bone healing rate, fatty muscle infiltration was progressive in more than half of the patients.

Level Of Evidence: Therapeutic case series, Level IV.