Atri LJ, Miranda OLA, Pareyón VRP, Gallegos TAG, Pérez-Salazar MD

Language: Spanish
References: 12
Page: 12-17
PDF size: 297.19 Kb.

ABSTRACT

Introduction: The subscapularis is the largest and strongest muscle of the rotator cuff. Besides being the main internal rotator of the shoulder, it is also a dynamic stabilizer. The subscapularis injury is frequently associated with other rotator cuff and long head of biceps injuries. Diagnosis can be challenging, considering that anterior shoulder pain is associated with many other injuries around that region. The magnetic resonance imaging has a moderate sensibility to identify these injuries, and many times the diagnosis is done during the surgery. The surgical repair has demonstrated to improve pain relief substantially and with a good satisfaction index by patients. Objetive: To report the arthroscopic management of the subscapularis and describe the associated injuries in the shoulder in the ABC Medical Center. Material and methods: In the year 2018 and 2019, 411 shoulder arthroscopies were performed in ABC Medical Center. 217 patients had a rotator cuff injury of which 104 had the subscapularis tendon affected (47.92%). In the statistical analysis, the Kolmogorov-Smirnov test was applied for these variables, with which it was verified that they had a normal distribution. The Student's t test was used for group comparison. The rest of variables are reported as a percentage (absolute value) and their comparison between groups is performed using Pearson's χ² test. The cut-off point for statistical significance is considered p < 0.05. Results: Of the 104 subscapularis injuries reported, 49.04% were treated with debridement and 50.96% were repaired. The use of only one knotless anchor predominates in repair. However, in 34% of the anchors used, the type of anchor and whether or not knots were used for the repair were not specified. In 28% of the cases in which more than one anchor was used, 80% were knotless. Conclusion: Half of the patients diagnosed with rotator cuff injuries have a subscapularis injury, many of them not previously diagnosed. As the subscapularis is a fundamental stabilizer in the shoulder, its repair is of utmost importance. A surgical technique is proposed and the incidence of subscapularis injury associated with rotator cuff injury has been reported during a two year period at ABC Medical Center.

REFERENCES

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EVIDENCE LEVEL

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