Short-term outcomes of anatomic total shoulder arthroplasty with biceps augmentation of subscapularis peel repair

Abstract

Background Augmenting subscapularis peel repairs with the long head of the biceps tendon (LHBT) may provide increased strength to the repaired construct. We aimed to report on the early outcomes of anatomic total shoulder arthroplasty (aTSA) in patients whose subscapularis peel repairs were augmented with LHBT autografts. Methods All patients who underwent aTSA with augmentation of subscapularis peel repair using LHBT were reviewed. Patients were included if they had a minimum 1-year follow-up. Preoperative demographics and intraoperative information were recorded. Primary outcomes were American Shoulder and Elbow Surgeon (ASES) scores and visual analog scale (VAS) pain scores, which were assessed at 3, 6, and 12 months, as well as changes in range of motion values. Results Sixteen patients with a mean age of 63.3 years and a mean follow-up of 12.4 months were included in the study. Six patients were female and 10 were male. Average LHBT length was 7.3 cm (range, 6.5–9.0 cm). Two patients were converted to reverse shoulder arthroplasty (12.5%). For the remaining 14 patients, there were statistically significant improvements exceeding the minimal clinically important difference in both ASES (34.1–92.1, P<0.001) and VAS (6.3–0.9, P<0.001) scores. Patients exhibited a mean improvement of 47.7° in forward elevation (P<0.001), 30.8° in abduction (P<0.001), 21.4° in external rotation (P<0.001), and a 3-level improvement for internal rotation. Conclusions At 1-year minimum follow-up, patients who underwent aTSA with augmentation of the subscapularis peel repair with the LHBT demonstrated favorable outcomes. Level of evidence IV.

Keywords

• total shoulder replacement
• arthroplasty
• subscapularis repair
• long head of the biceps tendon