Monday, April 4, 2016

Reverse total shoulder - is it important to reattach the subscapularis?

The influence of subscapularis tendon reattachment on range of motion in reversed shoulder arthroplasty: a clinical study.

These authors contacted 127 of their patients having an Aequalis reverse shoulder prosthesis. Of these 65 (mean age of 73.8 years, range 47-90) agreed to participate in the followup study.

At the time of surgery 40 of these patients (61.5 %) they found that the quality of the tendon was initially insufficient for repair. 
The subscapularis was repaired in 25 patients (38.5 %).
On ultrasound examination, 10 (40 %) out of 25 repaired subscapularis tendons were still sufficient. 

Postoperatively, range of motion, strength, Constant-Murley and Oxford scores did not differ significantly between repair with present tendon, repair with absent tendon or no repair.

Comment: While the authors were careful to describe the limitations of this retrospective study, including the number of patients lost to followup and the lack of preoperative scores and exam data, the data do not suggest a difference among the intact repair, failed repair and non-repair groups.

In spite of these data, it makes sense to us to repair the subscapularis when the tissue allows for a good quality repair. Our current technique is shown in this post.

Use the "Search" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'