Comparison of Open Versus Arthroscopic Repair for Subscapularis Tendon Tears With or Without Concomitant Supraspinatus Tendon Tears.

BACKGROUND

The literature comparing open and arthroscopic repair of subscapularis tendon (ST) tears is insufficient.

PURPOSE

To compare the clinical results of open versus arthroscopic repair of ST tears with or without concomitant supraspinatus tears.

STUDY DESIGN

Retrospective cohort study.

METHODS

We retrospectively evaluated 70 patients treated for isolated ST tears and ST tears with concomitant supraspinatus tendon tears at a single center between 2011 and 2019. Patients were divided into 2 groups: those who underwent open ST repairs (group O) and those with an arthroscopic ST repair (group A). Range of motion (ROM), liftoff and belly-press tests, and Constant-Murley (CM) scores were included in the pre- and postoperative functional evaluations. The minimal clinically important difference was calculated using the anchor-based method for changes in CM score. Tear size was evaluated according to the Lafosse classification. The categorical data were assessed using the Pearson chi-square, Fisher exact, and Fisher-Freeman-Halton tests. The parametric and nonparametric data were evaluated using the Student test and Mann-Whitney test, respectively. The dependent groups (for nonnormally distributed data) were evaluated using the Wilcoxon signed rank test.

RESULTS

Group O included 34 patients, and group A included 36 patients. The mean age was 62.9 years, and the mean follow-up period was 66.7 months. Even though group O exhibited a significantly better preoperative CM score (53.7 ± 4.6 vs 48.9 ± 6.8 [mean ± SD]; = .001), group A had a significantly better postoperative CM score (88.7 ± 4.7 vs 84.6 ± 2.9; < .001). Our measurements revealed a minimal clinically important difference of 11.5 points for the CM score. Group A had significantly greater postoperative ROM in abduction (153° vs 143.9°; = .005) and forward elevation (159.1° vs 149.7°; = .005), as well as significantly greater postoperative improvement in positive belly-press test results ( = .028). Complications occurred in 4 patients in group O and in 1 patient in group A.

CONCLUSION

The study findings indicated that arthroscopic ST repair was more advantageous than open repair in terms of ROM and functional outcomes.