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A classification for partial subscapularis tendon tears.

Frank Martetschläger1,2, Frantzeska Zampeli3, Mark Tauber3,4

  • 1Department of Shoulder and Elbow Surgery, ATOS Clinic Munich, Effnerstraße 38, 81925, Munich, Germany. frank.martetschlaeger@atos.de.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|April 15, 2020
PubMed
Summary
This summary is machine-generated.

This study introduces a new classification for partial subscapularis tendon (SSC) tears, detailing their size and impact. The findings show these tears can significantly affect internal rotation strength and motion.

Keywords:
ClassificationPartial lesionRotator cuffSubscapularis

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Musculoskeletal Imaging

Background:

  • Partial tears of the subscapularis tendon (SSC) are common shoulder injuries.
  • Accurate classification is crucial for understanding tear characteristics and guiding treatment.
  • Existing classifications may not fully capture the complexity of partial SSC tears.

Purpose of the Study:

  • To develop and present a novel, descriptive classification system for partial subscapularis tendon tears.
  • To analyze the characteristics of partial SSC tears using arthroscopic assessment.
  • To correlate tear characteristics with functional outcomes such as internal rotation strength and range of motion.

Main Methods:

  • Retrospective analysis of 50 patients with arthroscopically confirmed partial SSC tears.
  • Measurement of internal rotation (IR) force and range of motion (ROM), compared to the contralateral healthy shoulder.
  • Standardized arthroscopic investigation of the SSC footprint, measuring mediolateral and craniocaudal extension of the tear.
  • Classification based on tear dimensions in transverse and coronal planes.

Main Results:

  • A classification system was developed, categorizing tears into split lesions (Type 1) and further groups (Types 2-4) based on mediolateral tear extension (<10mm, 10-15mm, >15mm).
  • Types 2-4 were further subdivided (Groups A-C) based on craniocaudal tear extension (<10mm, 10-15mm, >15mm).
  • Significant decreases in IR strength were observed in Types 2-4, and significant decreases in active IR ROM were noted across all types (except Type 3 for passive ROM) compared to the healthy side.

Conclusions:

  • A novel classification for partial subscapularis tendon tears provides a more detailed and reproducible description.
  • This classification can enhance understanding and inform appropriate treatment strategies for partial SSC tears.
  • Partial SSC tears demonstrably impact internal rotation strength and motion, highlighting the clinical relevance of accurate tear assessment.