Repairability of the subscapularis tendon in reverse shoulder prosthesis according to radiological findings

Abstract

Shoulder function is important in patients who underwent reverse shoulder prosthesis surgery for cuff tear arthropathy in the postoperative period to implement their daily routines. Therefore, we aimed to predict the repairability of the subscapularis tendon in reverse shoulder arthroplasty by looking at the radiological findings. A total of 107 shoulders of 101 patients were examined retrospectively. Preoperative and postoperative shoulder AP radiographs of the patients were evaluated according to acromiohumeral distance, lateral humeral offset, acromiohumeral distance difference, lateral humeral offset difference, Hamada classification, and rotator cuff Goutallier staging. The subscapularis tendon could not be repaired in 31 (28.97%) of 107 shoulders and could not be repaired in 13 of 17 patients who used an onlay prosthesis. There was no significant correlation between preoperative Hamada staging, preoperative lateral humeral offset and lateral humeral offset difference, and subscapularis repair ( p < 0.05). Preoperative and postoperative acromiohumeral distance cut-off values were found to be 0.59 and 3.22 cm, respectively. A statistically significant correlation was found in terms of preoperative acromiohumeral distance, postoperative acromiohumeral distance, acromiohumeral distance difference, Goutallier stage with the repair of subscapularis tendon. Fatty atrophy in rotator cuff muscles and distalization of the humerus can be considered as negative predictive values in terms of repairability of the subscapularis tendon.