Ten-year clinical and magnetic resonance imaging evaluation after repair of isolated subscapularis tears

Abstract

Hypothesis: The purpose was to evaluate long-term clinical outcomes and tendon structural integrity after repair of isolated subscapularis (SSC) tendon tears. Methods: Sixty-one patients who underwent repair of isolated SSC tears were evaluated. The mean interval from symptom onset to surgery was 5.3 months. Shoulder function was investigated using the Constant score and Subjective Shoulder Value (SSV). Structural integrity of the repair and quality of the repaired tendon were assessed using magnetic resonance imaging. Independent preoperative factors affecting clinical outcomes, including patient sex, age, smoking habits, injections, dominant shoulder, profession, and tear onset (chronic vs. traumatic), were evaluated. Results: A total of 35 patients (9 women and 26 men; mean age, 54 years) were included at the final 10-year follow-up because 21 patients were lost to follow-up and 5 underwent reoperations. The mean Constant score improved from 55.1 points preoperatively to 75.4 points postoperatively (P = .001). The postoperative SSV was 80.9, and the retear rate was 12.9%. Postoperative fatty infiltration increased in 26% of the patients with grades 3-4, but it was not related to lower clinical outcomes. Multivariable regression analysis revealed no correlation among the preoperative factors, including sex, age, smoking habits, injections, dominant shoulder, profession, and tear onset, and the postoperative Constant score, SSV, and tendon healing. Conclusion: At a mean of 10 years after repair of isolated SSC tears, clinical results were satisfactory and functional improvement was maintained in the long term. Severe fatty infiltration increased with time, but it was not related to clinical outcomes and the retear rate.

Keywords

• Subscapularis repair
• MRI
• long-term results
• fatty infiltration
• retear
• isolated subscapularis tendon tears