Steadman Hawkins Clinic of the Carolinas, Greenville Hospital System, Greenville, SC, USA.
J Shoulder Elbow Surg. 2012 Jan;21(1):36-41. doi: 10.1016/j.jse.2011.04.009. Epub 2011 Jul 31.
Despite improved results with reverse shoulder arthroplasty (RSA), questions still remain regarding certain technical aspects of the operation. One particular area of question is the effect of subscapularis repair on complication rates, dislocation, pain, and overall range of motion. Some authors suggest that when a deltopectoral approach is used, not repairing the subscapularis leads to a higher complication rate, especially for dislocation.
From a reverse total shoulder arthroplasty database of 3 surgeons at 1 institution, we identified 55 patients who underwent RSA using the deltopectoral approach without subscapularis repair and 65 patients with subscapularis repair.
Complications were documented in 11 of 55 shoulders (20%) without subscapularis repair and in 13 of 65 shoulders (20%) with subscapularis repair. Dislocation occurred in 3 shoulders in the nonrepair group and in 2 shoulders in the repair group. These data indicate that nonrepair of the subscapularis did not have a significant effect on the risk of any complication, dislocation, infection, disassociation, or function.
Repairing the subscapularis has no appreciable effect on complication rate, dislocation events, or range of motion gains and pain relief.
尽管反肩置换术（RSA）的效果有所改善，但手术的某些技术方面仍存在问题。一个特别值得关注的问题是肩胛下肌修复对并发症发生率、脱位、疼痛和整体活动范围的影响。一些作者认为，当使用三角肌胸大肌入路时，不修复肩胛下肌会导致更高的并发症发生率，尤其是脱位。
我们从 1 家机构的 3 位外科医生的反全肩关节置换数据库中，确定了 55 例接受三角肌胸大肌入路不修复肩胛下肌的 RSA 患者和 65 例肩胛下肌修复患者。
在未修复肩胛下肌的 55 个肩中有 11 个（20%）发生并发症，在修复肩胛下肌的 65 个肩中有 13 个（20%）发生并发症。在非修复组中，有 3 个肩发生脱位，在修复组中有 2 个肩发生脱位。这些数据表明，不修复肩胛下肌对任何并发症、脱位、感染、分离或功能丧失的风险没有显著影响。
修复肩胛下肌对并发症发生率、脱位事件或活动范围的增加和疼痛缓解没有明显影响。
