2017 ISAKOS Biennial Congress ePoster #2224

 

Arthroscopic Subscapularis Repair Using a Single Anchor - Functional and Structural Outcome

Karthik S. Murugappan, MBBS, MS(Orth), DNB, MRCS, Coimbatore, Tamil Nadu INDIA
Arul Daniel, MBBS,Diploma Orthpeadics,DNB orthopeadics,FPO,FASM, Kolar, Karnataka INDIA
David V. Rajan, MS(Orth), MNAMS(Orth), FRCS(G), Coimbatore, Tamil Nadu INDIA

ortho one - Orthopaedic Specialty Centre, coimbatore, tamil Nadu, INDIA

FDA Status Cleared

Summary

Repair of the subscapularis with a single anchor offers a stable repair with good functional outcome at the end of one year. the subscapularis with a single anchor offers a stable repair with good functional outcome at the end of one year.

Abstract

Background

With increasing understanding of subscapularis lesions, repair of torn subscapularis tendon is becoming a common surgery. Using proper technique, restoring the subscapularis to its footprint could be done using a single anchor.

Materials And Methods

From Jan 2012 to June 2013, out of 154 patients who underwent arthroscopic rotator cuff repair, 64 patients were chosen for study. 60 had associated posterosuperior cuff tear. Only patients with Lafosse type 2 and type 3 tears were included in the study. 70 degree scope was used to visualise subscapularis footprint. Lafosse Type 2 and Type 3 tears were repaired with a single double loaded suture anchor. Associated supraspinatus and infraspinatus were repaired as needed. Patients followed a standard post operative protocol and reviewed periodically. At 9 months, a repeat MRI was done to evaluate the intactness of repair. ASES and Oxford Shoulder scores were used for clinical evaluation at one year.

Results

Mean age of patients was 54.5 years. All patients had improved ASES and Oxford Shoulder Scores at the end of one year. There was no subjective complaint of stiffness in any patient. ROM improved in all directions. One patient developed Type I CRPS which responded to treatment. Graded Belly press test was negative at one year in all patients. MR showed re tear or incomplete healing in 8 patients but these patients were asymptomatic at one year. The presence of posterosuperior cuff tear did not influence the results of subscapularis repair.

Conclusion

A single double loaded suture anchor repair provides good functional and structural outcome in Type 2 and Type 3 subscapularis tears. The presence of concomitant pathology does not affect the outcome. Repairing the subscapularis rather than ignoring it improves functional outcome in patients.