Postoperative Outcomes are Comparable Between Arthroscopic Subscapularis Repairs Performed with either All-Suture Anchors or Hard-Body Anchors

Abstract

PurposeTo compare clinical outcomes and tendon healing rates of patients undergoing arthroscopic rotator cuff repairs (ARCR) involving the subscapularis (SSC) tendon (isolated or combined) with all-suture anchors (ASAs) versus hard-body anchors (HBAs). Our secondary objective was to compare SSC healing rates between these two anchors. MethodsA retrospective comparative study was performed on patients who underwent ARCR of the SSC with either ASAs or HBAs and had minimum 2-year follow-up. Range of motion and patient-reported outcomes (PROs) were collected pre- and postoperatively, including Visual Analogue Scale for pain (VAS), American Shoulder and Elbow Surgeons score (ASES), and Subjective Shoulder Value (SSV). Postoperative strength was measured including Constant strength and belly press test. SSC healing was evaluated on ultrasounds at the final follow-up. Results84 patients met the study criteria. Twenty-eight underwent SSC repair with ASAs and 56 with HBAs. The mean follow-up for the ASA group and HBA group was 44 ± 22.7 months, and 48.4 ± 28.3, respectively (P=.743). Baseline characteristics were comparable between groups (P>.05). Overall, PROs and ROM showed significant improvements from baseline to the final follow-up in all groups (P<.001). Postoperatively, patients in the ASA group had greater improvement in forward flexion compared to the HBA group: 31º (95% CI, 20º – 42º) vs 14º (95% CI, 5º – 8º), respectively (P=.002). Postoperative Constant strength was higher in the ASA group compared to the HBA group: 17.5 ± 7.5 vs 13.5 ± 5.6, respectively (P=.04). No statistically significant difference in SSC retear rates was observed between groups: none in the ASA group, and 3 (10.7%) in the HBA group (P=.27). ConclusionArthroscopic SSC repair leads to significant functional improvement, with both ASAs and HBAs demonstrating similar low failure rates. Level of EvidenceRetrospective Cohort study; Level of evidence 3.