Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Clin Orthop Surg. 2024 Aug;16(4):594-601. doi: 10.4055/cios23389. Epub 2024 Jul 12.
The purpose of this study was to identify the changes in untreated subscapularis in patients who underwent supraspinatus repair and to evaluate the factors related to the changes in the subscapularis.
A cohort of patients who underwent isolated supraspinatus repair with preservation of the subscapularis was reviewed. Changes in the subscapularis, including any newly formed lesion and aggravation of an existing lesion, were evaluated 12 months postoperatively on magnetic resonance imaging along with an examination to identify causative factors after supraspinatus repair. Clinical scores were compared between patients with and without subscapularis changes.
A total of 528 patients were reviewed. Changes in the subscapularis, including newly formed lesions and aggravation of an existing lesion, were shown in 90 patients (17.0%). Upon regression analysis, changes in the subscapularis were associated with the initial existence of a subscapularis lesion (grade I: = 0.042, grade II: = 0.025), an accompanying biceps lesion ( = 0.038), and a retear of the repaired supraspinatus ( = 0.024). No significant differences were shown in clinical scores between patients with and without subscapularis changes after supraspinatus repair.
Untreated asymptomatic subscapularis may undergo morphological changes even after repair of the torn supraspinatus. Preoperative subscapularis lesions, biceps long head pathology, and retears of the repaired supraspinatus were associated with subscapularis pathology in patients who underwent supraspinatus repair.
本研究旨在确定接受冈上肌修复术的患者未治疗的肩胛下肌的变化，并评估与肩胛下肌变化相关的因素。
回顾性分析了一组接受保留肩胛下肌的单纯冈上肌修复的患者。术后 12 个月，通过磁共振成像评估肩胛下肌的变化，包括任何新形成的病变和现有病变的加重，并检查冈上肌修复后的致病因素。比较肩胛下肌变化患者和无变化患者的临床评分。
共回顾了 528 例患者。90 例（17.0%）患者肩胛下肌出现变化，包括新形成的病变和现有病变的加重。回归分析显示，肩胛下肌的变化与肩胛下肌病变的初始存在（I 级： = 0.042，II 级： = 0.025）、伴随的二头肌病变（ = 0.038）和修复后的冈上肌再撕裂（ = 0.024）有关。冈上肌修复后，肩胛下肌变化患者和无变化患者的临床评分无显著差异。
即使在撕裂的冈上肌修复后，未治疗的无症状肩胛下肌也可能发生形态变化。术前肩胛下肌病变、二头肌长头病变和修复后的冈上肌再撕裂与接受冈上肌修复术的患者的肩胛下肌病变有关。
