2015 ISAKOS Biennial Congress ePoster #2105

The Analysis of the Relationship Between Subscapularis Tendon Tear and Coracohumeral Distance

Kyoung-Jin Park, MD, PhD, Cheongju, Chungbuk KOREA, REPUBLIC OF
Yong Min Kim, MD, Cheongju, Chungbuk KOREA, REPUBLIC OF
Eui-Sung Choi, MD, PhD, Cheongju, Chungbuk KOREA, REPUBLIC OF
Hyun-Chul Shon, MD, Cheongju, Chungbuk KOREA, REPUBLIC OF
Suri Chong, MD, Cheong-Ju KOREA, REPUBLIC OF
Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University , Cheongju , Chungbuk , KOREA

FDA Status Not Applicable

Summary: Statistical analysis showed that the coracohumeral distance was not significantly narrowed in the group of patients. These results show that narrowing of coracohumeral distanace is not a main cause of subscapularis rupture. So further studies are required for etiology of subscapularis tear.

Abstract:

Purpose

It has been controversial for a long time whether subcoracoid impingement syndrome is cause of subscapularis tear. So this study aimed to determine the relationship between the coracohumeral distance and subscapularis tear and to evaluate the associated shoulder pathology in patients with complete subscapularis tendon tear.

Material And Methods

The coracohumeral distance of complete subscapularis tear patients requiring an arthroscopic repair (n = 32 shoulders) and patients of partial subscapularis tear(n=40) was compared with a control group (n = 61). The coracohumeral distance was measured from the tip of the coracoid to the cortex of the proximal humerus on an axial cut of preoperative magnetic resonance imaging. To analysis the factor that is associated with the complete subscapularis tendon tear, the size of tear, grade of fatty degeneration, biceps tendon pathology, combined rotator cuff tear were evaluated.

Results

The The average coracohumeral distance in the complete subscapularis tear group was 8.95 ± 2.56 mm and the average coracohumeral distance in partial subscapularis tear group was 8.66± 2.63 mm. The control group was 9.53 ± 2.65 mm. The dislocation, subluxation or complete tear of long head of biceps tendon was combined in 68 % of complete subscapularis tendon patients. Average tear size of subscapularis was 24.30 vs 15.63mm in patients wth a Goutallier grade of 0,1,2 to 3 or 4. All the patientsof Goutallier grade 4 (n=7) had combined rotator cuff tear. Average coracohumeral distance was decreased(7.48mm) in patients(n=4) with complete subscapularis tear with a supraspinatues and infraspinatus tear.

Conclusion

Statistical analysis showed that the coracohumeral distance was not significantly narrowed in the group of patients. These results show that narrowing of coracohumeral distanace is not a main cause of subscapularis rupture. So further studies are required for etiology of subscapularis tear. And the size and combined rotator cuff tear of complete subscapularis tendon tear was affected by the degree of fatty degeneration. So measuring Goutallier grade would be helpful to predict the size and combined rotator cuff tear.