Medialization of the subscapularis footprint does not affect functional outcome of arthroscopic repair

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.