Abstract
BackgroundThe study aimed to explore the additional value of repair of Lafosse I subscapularis injury compared with debridement in anterosuperior rotator cuff injury.MethodsThe prospective study was conducted on a total of 41 patients with supraspinatus tendon tear combined with Lafosse I subscapularis injury. Eighteen patients were divided into the repair group and 23 patients were divided into the non-repair group. The two groups were compared for intraoperative parameters, pain score, range of motion of the shoulder joint, shoulder joint function and quality of life (QoL) at pre-operation, 3 and 6 months postoperatively and the final follow-up visit.ResultsThe width of supraspinatus tendon tear did not exceed 3 cm and did not retract beyond the glenoid in among patients. There was no statistical difference of preoperative data between two groups, including age, course of disease, positive Jobe test, positive Bear-hug test, positive Lift-off test, Patte stage, longitudinal tear and pain severity (P > 0.05). Compared to preoperative levels, the severity of pain, ASES scores and EQ-5D-3L scores were significantly lower at 3 and 6 months postoperatively and the final position (P < 0.05). However, there was no statistical difference in pain severity, ASES scores and EQ-5D-3L scores between repair group and non-repair group (P > 0.05). Similarly, compared to preoperative levels, the range of motion of shoulder joint was significantly improved after operation, including internal rotation, external rotation, forward flexion and elevation (P < 0.05). However, there was no statistical difference in range of motion of shoulder joint between repair group and non-repair group (P > 0.05).ConclusionOperative treatment can effectively lessen severity of pain in the patients, improve shoulder joint function, increase the range of motion of the shoulder joint and enhance the QoL in treating anterosuperior rotator cuff injury. However, repair of subscapularis brings no benefit compared to debridement in treating supraspinatus tendon tear combined with Lafosse I subscapularis injury.
Highlights
Over the recent years, the incidence of rotator cuff injury is approximately 30% in persons aged above 60 years and rotator cuff injury has been an important social issue with the acceleration of population aging [1]
Repair of subscapularis brings no benefit compared to debridement in treating supraspinatus tendon tear combined with Lafosse I subscapularis injury
Katthagen et al [17] treated 65 cases of anterosuperior rotator cuff injury by local debridement of Lafosse I subscapularis injury after repair of the supraspinatus tendon, and the patients were followed up for 12 months postoperatively, and the results showed that the treatment effectively increased shoulder joint function of the patients, reduced pain scores and lessened the severity of pain
Summary
The incidence of rotator cuff injury is approximately 30% in persons aged above 60 years and rotator cuff injury has been an important social issue with the acceleration of population aging [1]. Zhao et al BMC Musculoskelet Disord (2021) 22:925 the incidence of subscapularis injury is low and open surgery was main method in clinical treatment, but it is difficult to diagnose Lafosse I and II subscapularis injury [3]. Previous studies showed that if Lafosse I injury is not promptly and effectively treated, the shoulder joint pain and the rotator cuff tear will be likely aggravated [7]. This study analyzed patients with supraspinous tendon tear combined with Lafosse I subscapularis injury, in order to explore the addittional value of repair of Lafosse I subscapularis injury in anterosuperior rotator cuff injury. The study aimed to explore the additional value of repair of Lafosse I subscapularis injury compared with debridement in anterosuperior rotator cuff injury
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