2017 ISAKOS Biennial Congress ePoster #2234

 

Concomitant Coracoplasty During Arthroscopic Subscapularis Repair: Is It Necessary for Better Clinical Outcomes and Structural Integrity?

Sung-Jae Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Min Jung, MD, PhD, Seoul KOREA, REPUBLIC OF
Sung-Hwan Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Wonyong Lee, MD, Painted Post, NY UNITED STATES
Jong-Min Kim, MD, Incheon, Gyeonggi KOREA, REPUBLIC OF
Yong-Min Chun, MD, PhD, Assoc. Prof., Seoul KOREA, REPUBLIC OF

Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, KOREA, REPUBLIC OF

FDA Status Not Applicable

Summary

For isolated subscapularis full-thickness tears, concomitant coracoplasty with arthroscopic repair did not produce better clinical outcomes or structural integrity than repair without coracoplasty. This suggests that concomitant coracoplasty may not be imperative during arthroscopic repair of isolated subscapularis full-thickness tears.

ePosters will be available shortly before Congress

Abstract

Purpose

Few studies have examined whether concomitant coracoplasty is necessary to improve clinical and radiological outcomes after arthroscopic subscapularis repair. The purpose of this study was to compare clinical outcomes and structural integrity after arthroscopic repair of isolated subscapularis full-thickness tear, either with or without concomitant coracoplasty.

Methods

This study included 62 patients who underwent arthroscopic subscapularis repair either with coracoplasty (Group A, 35 patients) or without coracoplasty (Group B, 27 patients). Preoperative and postoperative visual analog scale (VAS) pain scores, subjective shoulder values (SSV), University of California at Los Angeles (UCLA) shoulder scores, American Shoulder and Elbow Surgeon (ASES) scores, subscapularis strength, and shoulder active range of motion (ROM) were assessed. Postoperative magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was performed 6 months postoperatively for structural integrity assessment.

Results

At 2-year follow-up, all functional scores and ROM improved significantly in both groups compared with preoperative values (p < 0.001). However, none of these values differed significantly between groups. On follow-up MRA or CTA images, although postoperative coracohumeral distance was significantly greater in Group B (7.0 mm versus 8.4 mm) (p = 0.018), the re-tear rates were not significantly different between groups (14% (5/35) in Group A and 15% (4/27) in Group B).

Conclusions

For isolated subscapularis full-thickness tears, concomitant coracoplasty with arthroscopic repair did not produce better clinical outcomes or structural integrity than repair without coracoplasty. This suggests that concomitant coracoplasty may not be imperative during arthroscopic repair of isolated subscapularis full-thickness tears.