Southern Oregon Orthopedics, Medford, Oregon, USA.
Arthroscopy. 2012 Nov;28(11):1608-14. doi: 10.1016/j.arthro.2012.02.030. Epub 2012 May 24.
The purpose of this study was to compare the functional outcome of arthroscopic subscapularis repair of complete subscapularis tendon tears performed with anatomic tendon-to-bone repair versus repair with medialization of the footprint.
A retrospective review was performed of subscapularis tendon tears repaired with an arthroscopic technique from 1998 to 2009. Complete tears of 100% of the length of the subscapularis tendon repaired arthroscopically were included in the study. The exclusion criteria included subscapularis tendon tears of less than 100% of the tendon length, revision repairs, or open repairs. The minimum follow-up was 2 years. Postoperative functional outcome was determined by University of California, Los Angeles and American Shoulder and Elbow Surgeons scores.
Group I comprised 14 tears that were anatomically repaired to the normal lesser tuberosity footprint. Group II comprised 9 tears that were repaired to the lesser tuberosity after medialization of the footprint. There was no difference in improvement in University of California, Los Angeles or American Shoulder and Elbow Surgeons scores between the 2 groups (P > .05). Furthermore, there was no difference in how patients rated their shoulder, patient satisfaction, or return to activity between the 2 groups (P > .05).
On the basis of this study, functional outcome does not appear to be compromised by medialization of the subscapularis footprint. Medialization by 4 to 7 mm is acceptable when tendon mobility is otherwise insufficient to perform an anatomic tendon-to-bone repair of a complete subscapularis tendon tear.
Level III, retrospective comparative study.
本研究旨在比较关节镜下肩胛下肌完全撕裂修复的功能结果，一种是解剖肌腱-骨修复，另一种是修复时采用附着点内移。
对 1998 年至 2009 年采用关节镜技术修复肩胛下肌腱撕裂的病例进行回顾性研究。本研究纳入了完全撕裂长度达肩胛下肌腱 100%的病例。排除标准包括肩胛下肌腱撕裂长度小于肌腱全长的 100%、翻修或开放修复的病例。最低随访时间为 2 年。术后功能结果通过加利福尼亚大学洛杉矶分校（UCLA）和美国肩肘外科医生（ASES）评分来确定。
I 组包括 14 例按解剖结构修复至正常小粗隆附着点的撕裂；II 组包括 9 例附着点内移修复至小粗隆的撕裂。两组患者的 UCLA 和 ASES 评分均有改善，但组间差异无统计学意义（P＞0.05）。此外，两组患者对肩部的评价、满意度或恢复活动能力方面无差异（P＞0.05）。
根据本研究，肩胛下肌附着点内移不会影响功能结果。当肌腱活动度不足以进行完全肩胛下肌腱撕裂的解剖肌腱-骨修复时，附着点内移 4 至 7mm 是可以接受的。
III 级，回顾性比较研究。
