Efficacy of the Subclavian Portal Approach in Arthroscopic Repair of Isolated Subscapularis Tendon Tear |
Seung Bum Chae, Chang Hyuk Choi, Suk Han Jung |
Department of Orthopaedic Surgery, College of Medicine, Catholic University of Daegu, Daegu, Korea. chchoi@cu.ac.kr |
|
Abstract |
BACKGROUND: To evaluate the efficacy of the subclavian portal approach for the arthroscopic repair of isolated subscapularis tendon tear. METHODS We used the subclavian portal to carry out arthroscopic repair of the isolated subscapularis tendon tear. The surgery was carried out in 18 cases (average age of 53) from May 2006 to December 2009 with a mean follow-up period of 35 months. Of these cases, 13 patients had the tear in their dominant arms, 16 were male, and 12 were from traumatic ruptures with on average 7.6 months of symptom period to operation. Additional surgery, acromioplasty and subacromial debridement, were carried out on 4 cases each during the subscapularis repair. The integrity of cuff status was assessed by ultrasonographic examination at 6 months and at 1 year after operation. RESULTS The initial average range of motion in forward flexion, external rotation, and internal rotation were 160degrees, 50degrees and L4, respectively. At the 1 year follow-up period, these improved to 160degrees, 52degrees and T12, respectively. The initial average functional scores were assessed by KSS, ASES, UCLA, and Constant scoring systems, which were 67, 60, 26, and 65, respectively. These scores improved progressively with time. At 3 months after operation, the scores were 74, 67, 27, and 74; at 6 months, 83, 77, 31, and 75; at 1 year, 88, 86, 32, and 79; and at the final follow-up of 35 months, 84, 92, 34, and 84. CONCLUSIONS In the repair of isolated subscapularis tendon tear, the subclavian portal approach provided a good angle for anchor insertion and sufficient space to manage the upper portion of the tendon tear. In turn, these provisions resulted in satisfactory clinical results. |
Key Words:
Subscapularis tendon; Subclavian portal; Suture anchor |
|