Arthroscopic Upper Third Subscapularis Tendon Repair Using H-Loop Technique: A Case Series.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Arthroscopy

Background:

• Arthroscopic repair of upper one-third subscapularis tendon tears presents challenges in suture management and achieving optimal repair quality.
• Existing techniques may have limitations in terms of simplicity and effectiveness.

Purpose of the Study:

• To evaluate the early clinical and imaging outcomes of a novel, simpler knotless arthroscopic technique—the H-Loop technique—for repairing upper one-third subscapularis tendon tears.
• To assess the functional recovery, range of motion, strength, and tendon integrity following H-Loop repair.

Main Methods:

• A case series of 38 patients undergoing arthroscopic H-Loop repair for upper one-third subscapularis tears.
• Postoperative assessment included ASES, UCLA, Constant-Murley scores, VAS pain scale, range of motion, and internal rotation strength.
• MRI evaluation in 30 patients assessed tendon integrity, fatty infiltration, and re-tears, with comparisons to a control group.

Main Results:

• Significant improvements were observed in ASES, UCLA, and Constant-Murley scores, alongside a decrease in VAS pain scores.
• Postoperative range of motion and internal rotation strength showed marked improvement.
• MRI revealed no re-tears or fatty infiltration, with no significant differences in subscapularis muscle dimensions or signal-to-noise ratios compared to controls.

Conclusions:

• The arthroscopic H-Loop technique is effective in restoring shoulder function, improving range of motion, and enhancing internal rotation strength.
• The technique demonstrates good tendon integrity in the early postoperative period, offering a promising alternative for subscapularis tear repair.