Summary
Both arthroscopic single-row and double-row suture bridge repairs of isolated full-thickness subscapularis tears seem comparable, yielding satisfactory clinical outcomes and structural integrity in patients with good quality cuff muscle.
Abstract
Purpose
The purpose of this study is to compare clinical outcomes and structural integrity after arthroscopic repair of an isolated subscapularis full-thickness tear using either the single-row or double-row suture-bridge technique. We hypothesized that both approaches would yield comparable clinical and radiological outcomes
Methods
This study included 56 patients who underwent arthroscopic repair of an isolated subscapularis full-thickness tear with grade II or less fatty infiltration in the subscapularis muscle, using either a single-row (Group A, n=31) or double-row suture-bridge technique (Group B, n=25). Functional outcomes were assessed using the Visual Analog Scale (VAS) pain score, subjective shoulder value (SSV), American Shoulder and Elbow Surgeons (ASES) score, the University of California at Los Angeles (UCLA) shoulder score, and active range of motion (ROM). Magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was performed 6 months after surgery to assess the structural integrity of the repaired tendon.
Results
At the 2-year follow-up, all scoring parameters applied (VAS, SSV, ASES, and UCLA), subscapularis strength, and active ROM improved significantly in both groups compared to preoperative values (p < 0.001). However, there were no significant differences between groups in any of these clinical outcome measurements (VAS, 1.2 vs. 1.1; SSV, 91.3 vs. 91.8; ASES 91.4 vs. 91.4; UCLA, 31.9 vs. 32.1). On follow-up MRA or CTA, the overall re-tear rate did not differ significantly different between Group A (13%, 4/31) and Group B (12%, 3/25) in follow-up MRA or CTA studies.
Conclusion
Both arthroscopic single-row and double-row suture bridge repairs of isolated full-thickness subscapularis tears seem comparable, yielding satisfactory clinical outcomes and structural integrity in patients with good quality cuff muscle.