• Arch Orthop Trauma Surg · May 2021

    Single-row vs. double-row refixation of the subscapularis tendon after primary anatomic shoulder arthroplasty.

    • Yacine Ameziane, Kristian Nikolaus Schneider, Georg Gosheger, Annika Mischke, Dominik Schorn, Carolin Rickert, and Dennis Liem.
    • Department of Orthopedics and Tumor Orthopedics, University Hospital Muenster, Albert-Schweitzer-Campus 1a, 48149, Muenster, Germany. Yacine.ameziane@ukmuenster.de.
    • Arch Orthop Trauma Surg. 2021 May 1; 141 (5): 725-731.

    BackgroundThe postoperative integrity of the subscapularis tendon after primary anatomical shoulder arthroplasty has a significant effect on postoperative results. A transosseus Single Row Refixation technique (SRR) has shown up to 30% of partial tears in literature, a modified Double Row Refixation technique (DRR) has biomechanically shown a significantly reduced tear rate, but is yet to be proven in a clinical setting. Thus, we compared the SRR to the DRR technique using clinical outcome parameters and ultrasound examination.Materials And Methods36 patients (40 shoulders; 20f, 16 m; øage: 66 years) were included in our retrospective cohort study. 20 shoulders were treated with the SRR technique (12f, 8 m; FU ø40.9 months) and 20 with the DRR technique (11f, 9 m; FU ø31.6 months). The SRR was performed with three to five transosseus mattress sutures. DRR consisted of two medial placed transosseus sutures and four laterally placed single tendon-to-tendon sutures. The postoperative subscapularis integrity was evaluated by ultrasound examination, the clinical outcome was assessed with the Constant-Murley Score (CS) and the American Shoulder and Elbow Surgeons Score (ASES).ResultsThe subscapularis tendon was intact in 14 patients (70%) after SRR, whereas 18 patients (90%) treated with the DRR demonstrated a sonographically intact postoperative subscapularis tendon. The CS was 61.4 points in the SRR cohort and 67.3 points in the DRR cohort (p = 0.314). No significant differences were found in both cohorts preoperative (øSRR: 21.3 points; øDRR: 16.2 points, p = 0.720) and postoperative absolute ASES Scores (øSRR: 70.2 points; øDRR: 73.0 points, p = 0.792). However, the DRR cohort showed a statistical tendency to a higher postoperative ASES increase than the SRR cohort (øSRR-ASES increase: 48.9 points; øDRR-ASES increase: 56.8 points, p = 0.067).ConclusionThe results of this study show that application of the DRR technique can significantly reduce the total rate of postoperative subscapularis tears what effects a clinical tendency towards higher ASES improvements and a better range of motion compared to the SRR technique.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        

    hide…