Background:

The literature comparing open and arthroscopic repair of subscapularis tendon (ST) tears is insufficient.

Purpose:

To compare the clinical results of open versus arthroscopic repair of ST tears with or without concomitant supraspinatus tears.

Study Design:

Retrospective cohort study.

Methods:

We retrospectively evaluated 70 patients treated for isolated ST tears and ST tears with concomitant supraspinatus tendon tears at a single center between 2011 and 2019. Patients were divided into 2 groups: those who underwent open ST repairs (group O) and those with an arthroscopic ST repair (group A). Range of motion (ROM), liftoff and belly-press tests, and Constant-Murley (CM) scores were included in the pre- and postoperative functional evaluations. The minimal clinically important difference was calculated using the anchor-based method for changes in CM score. Tear size was evaluated according to the Lafosse classification. The categorical data were assessed using the Pearson chi-square, Fisher exact, and Fisher-Freeman-Halton tests. The parametric and nonparametric data were evaluated using the Student t test and Mann-Whitney U test, respectively. The dependent groups (for nonnormally distributed data) were evaluated using the Wilcoxon signed rank test.

Results:

Group O included 34 patients, and group A included 36 patients. The mean age was 62.9 years, and the mean follow-up period was 66.7 months. Even though group O exhibited a significantly better preoperative CM score (53.7 ± 4.6 vs 48.9 ± 6.8 [mean ± SD]; P = .001), group A had a significantly better postoperative CM score (88.7 ± 4.7 vs 84.6 ± 2.9; P < .001). Our measurements revealed a minimal clinically important difference of 11.5 points for the CM score. Group A had significantly greater postoperative ROM in abduction (153° vs 143.9°; P = .005) and forward elevation (159.1° vs 149.7°; P = .005), as well as significantly greater postoperative improvement in positive belly-press test results (P = .028). Complications occurred in 4 patients in group O and in 1 patient in group A.

Conclusion:

The study findings indicated that arthroscopic ST repair was more advantageous than open repair in terms of ROM and functional outcomes.

中文翻译：

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肩胛下肌腱撕裂与冈上肌腱撕裂的开放与关节镜修复的比较

背景：

比较肩胛下肌腱 (ST) 撕裂的开放式和关节镜下修复的文献不足。

目的：

比较开放性与关节镜下 ST 撕裂修复术与或不伴有冈上肌撕裂的临床结果。

学习规划：

回顾性队列研究。

方法：

我们回顾性评估了 2011 年至 2019 年间在单个中心接受治疗的 70 例单纯 ST 撕裂和伴有冈上肌腱撕裂的 ST 撕裂患者。患者分为 2 组：接受开放式 ST 修复（O 组）和接受关节镜 ST修理（A组）。运动范围 (ROM)、提举和腹部按压测试以及 Constant-Murley (CM) 评分包括在术前和术后功能评估中。使用基于锚的方法计算 CM 评分变化的最小临床重要差异。根据 Lafosse 分类评估泪液大小。使用 Pearson 卡方检验、Fisher 精确检验和 Fisher-Freeman-Halton 检验评估分类数据。使用 Student t评估参数和非参数数据检验和 Mann-Whitney U检验。依赖组（对于非正态分布的数据）使用 Wilcoxon 符号秩检验进行评估。

结果：

O组包括34名患者，A组包括36名患者。平均年龄为 62.9 岁，平均随访时间为 66.7 个月。尽管 O 组术前 CM 评分明显更好（53.7 ± 4.6 vs 48.9 ± 6.8 [平均值 ± SD]；P = .001），但 A 组术后 CM 评分明显更好（88.7 ± 4.7 vs 84.6 ± 2.9；P < .001)。我们的测量结果显示 CM 评分的最小临床重要差异为 11.5 分。A 组在外展（153° vs 143.9°；P = 0.005）和向前抬高（159.1° vs 149.7°；P = 0.005）方面的术后 ROM 显着增加，并且腹部按压试验阳性的术后改善显着更大结果（P= .028)。O组4例患者、A组1例患者出现并发症。

结论：

研究结果表明，关节镜下 ST 修复在 ROM 和功能结果方面比开放修复更有利。