All-arthroscopic glenoid reconstruction by iliac crest bone graft transfer does not affect structural integrity and 3-dimensional volume of the subscapularis muscle.

Abstract

The subscapularis muscle is an important active stabilizer of the glenohumeral joint. For this radiological study, we investigated if its radiological integrity is affected after arthroscopic glenoid reconstruction. In the technique used, an autologous iliac crest graft is transported through the rotator interval, and the graft is fixed via an antero-inferior portal with compression screws. 3 women and 6 men (mean age 31 ± 9years, min 21, max 46years) who had a preoperative glenoid deficit of 23% ± 6% (min 13%, max 29%) were included. In a follow-up after an interval of 34months (min 19, max 50), MRI scans were performed on both shoulders. With ITK-SNAP, a 3D reconstruction software, the volume of the subscapularis muscle in the injured and contralateral shoulder was measured. In addition, signal intensity ratios (PSI) (infraspinatus muscle / cranial subscapularis muscle and infraspinatus muscle / caudal subscapularis muscle) were analyzed and the width of the cranial and caudal portions as well as the length of the subscapularis muscle in the parasagittal plane were determined. The 3D volume showed no difference between operated and healthy shoulders (p = 0.07), neither did PSI ratios (infraspinatus muscle / cranial subscapularis muscle: p = 1.00, infraspinatus muscle / caudal subscapularis muscle: p = 1.00). In the parasagittal plane, length (p = 0.09) and cranial width (p = 0.23) did not differ. However, the width of the lower muscle was increased in injured shoulders (p = 0.02). In this cohort, no relevant volume loss could be found after arthroscopic glenoid reconstruction. However, a greater width of the lower muscle portion could be identified in the parasagittal plane as a possible indication of scarring.