Open repair of subscapularis tendon tears leads to complete relief of symptoms in the majority of patients, but often fails to restore functional range of motion

Timon H. Geurkink, Bart W Oudelaar, C. Overbeek, Jorrit Jasper, Rob GHH Nelissen, J. Nagels
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Abstract

To investigate the outcome of open subscapularis (SSC) repair in terms of complete relief of symptoms, regaining functional range of motion ((ROM), i.e. minimum ROM to complete all tasks of daily living) and retear rate. Sixty-one patients who underwent open SSC repair between 2012 and 2019 were included in a retrospective cohort study. Primary outcome measures (complete relief of symptoms, obtaining functional ROM, SSC retears), were assessed at minimum 1-year follow-up. Prognostic factors for these outcome measures were identified. At final follow-up, 44 patients (72%) reported complete relief of symptoms. Pre-operatively, 23 patients (40%) had a functional ROM, which increased to 33 patients (54%) post-operatively. Eight Patients (13%) had a retear after a median follow-up of 21 months (range: 3-35). Lafosse type IV tears were associated with having persisting symptoms (OR 5, 95 confidence interval (CI) 1.2–17.9, p = 0.024) and retears (OR 7, 95 CI 1.9–37.7, p = 0.031). The majority of patients reported complete relief of symptoms after SSC repair; however, only 54% obtained a functional ROM. Measuring outcome in terms of complete relief symptoms and regaining functional ROM is useful for the surgeon to evaluate the effect of surgical intervention and provides tangible information for patients.
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开放式肩胛下肌腱撕裂修复术可使大多数患者的症状得到完全缓解,但往往无法恢复功能性活动范围
目的:研究开放性肩胛下肌(SSC)修复术在完全缓解症状、恢复功能性活动范围(ROM,即完成所有日常生活任务的最小活动范围)和再撕裂率方面的效果。一项回顾性队列研究纳入了在2012年至2019年期间接受开放式SSC修复术的61名患者。主要结局指标(症状完全缓解、获得功能性 ROM、SSC 再撕裂)在至少 1 年的随访中进行评估。研究还确定了这些结果指标的预后因素。在最终随访中,44 名患者(72%)报告症状完全缓解。术前,23 名患者(40%)有功能性 ROM,术后增至 33 名患者(54%)。8名患者(13%)在中位随访21个月后(范围:3-35个月)再次撕裂。拉弗塞 IV 型撕裂与持续症状(OR 5,95 置信区间 (CI):1.2-17.9,P = 0.024)和再次撕裂(OR 7,95 置信区间 (CI):1.9-37.7,P = 0.031)有关。大多数患者在进行 SSC 修复术后症状完全缓解,但只有 54% 的患者获得了功能性 ROM。以症状完全缓解和恢复功能性 ROM 来衡量疗效,有助于外科医生评估手术干预的效果,并为患者提供切实的信息。
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