Akan Mehmet, Akyürek Muhlik, Koraman Emre, İyetin Yusuf, Türkmen İsmail
İstanbul Medeniyet University Goztepe City Hospital, Orthopaedics and Traumatology, İstanbul, Turkey.
Maria-Josef-Hospital, Orthopaedics and Traumatology, Greven, Germany.
Orthop J Sports Med. 2025 Jun 16;13(6):23259671251341914. doi: 10.1177/23259671251341914. eCollection 2025 Jun.
Subcoracoid cysts (ScCs) are often associated with rotator cuff tears, but their relationship with rotator cuff retears remains unclear.
To investigate the correlation between ScCs and retears in patients having undergone arthroscopic rotator cuff repair.
Cohort study; Level of evidence, 3.
A retrospective analysis was conducted on patients who underwent arthroscopic rotator cuff repair from November 2016 to March 2022. Patients with Patte stage 1 or 2 tears were included. Preoperative magnetic resonance imaging (MRI) assessed subscapularis and supraspinatus tendons, biceps pulley, and ScC volume. Postoperative MRI evaluated the same parameters as preoperative MRI, with the addition of rotator cuff retear assessment. On the basis of preoperative MRI, patients were classified into group A (with cyst) and group B (without cyst). According to postoperative MRI, groups were further divided into A1 (without retear), A2 (with retear), B1 (without retear) and B2 (with retear). Postoperative decrease in ScC volume (ScC delta), Sugaya classification, and Constant score were compared.
The study included 109 patients: 69 in group A (A1 = 40, A2 = 29) and 40 in group B (B1 = 35, B2 = 5). The retear rate was significantly higher in group A (34.8%) than in group B (12.5%) ( = .02). In group A, the median (minimum-maximum) ScC delta value was significantly greater in group A1 (2422 mm [257 to 7503 mm]) compared with group A2 (625 mm [-1060 to 1978 mm]), indicating no recurrence of the ScC ( = .03). Postoperative Constant shoulder scores were higher in the no retear groups (group A1, 79.3 ± 8.2; group A2, 66.2 ± 13.4; group B1, 83.2 ± 8.5; group B2, 61.4 ± 5.9) ( < .001).
For the patients with ScCs detected on preoperative MRI scans, preserved tendon integrity after rotator cuff repair was associated with a reduction in ScC volume. This reduction was evident on postoperative MRI scans when compared with preoperative measurements. Conversely, compromised tendon integrity did not lead to a significant reduction in ScC volume after surgery, potentially suggesting cyst reformation. Therefore, the postoperative identification of an ScC may indirectly indicate rotator cuff retear.
喙突下囊肿（ScC）常与肩袖撕裂相关，但其与肩袖再撕裂的关系仍不明确。
探讨关节镜下肩袖修复术后ScC与再撕裂之间的相关性。
队列研究；证据等级，3级。
对2016年11月至2022年3月期间接受关节镜下肩袖修复的患者进行回顾性分析。纳入Patte 1期或2期撕裂的患者。术前磁共振成像（MRI）评估肩胛下肌和冈上肌腱、肱二头肌滑车以及ScC体积。术后MRI评估与术前MRI相同的参数，并增加肩袖再撕裂评估。根据术前MRI，将患者分为A组（有囊肿）和B组（无囊肿）。根据术后MRI，将两组进一步分为A1（无再撕裂）、A2（有再撕裂）、B1（无再撕裂）和B2（有再撕裂）。比较术后ScC体积减少量（ScC增量）、Sugaya分类和Constant评分。
该研究纳入109例患者：A组69例（A1 = 40例，A2 = 29例），B组40例（B1 = 35例，B2 = 5例）。A组的再撕裂率（34.8%）显著高于B组（12.5%）（P = .02）。在A组中，A1组（2422 mm[257至7503 mm]）的ScC增量中位数（最小值 - 最大值）显著大于A2组（625 mm[-1060至1978 mm]），表明ScC无复发（P = .03）。无再撕裂组的术后Constant肩关节评分更高（A1组，79.3±8.2；A2组，66.2±13.4；B1组，83.2±8.5；B2组，61.4±5.9）（P < .001）。
对于术前MRI扫描发现有ScC的患者，肩袖修复后保留的肌腱完整性与ScC体积减小相关。与术前测量相比，术后MRI扫描显示这种减小很明显。相反，肌腱完整性受损在术后并未导致ScC体积显著减小，这可能提示囊肿再形成。因此，术后ScC的识别可能间接表明肩袖再撕裂。
