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Related Experiment Video

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Reverse Total Shoulder Arthroplasty
10:10

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Published on: July 5, 2011

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

Yi-Tao Yang1, Zhuo Wang1, Chen-Yang Meng1

  • 1Department of Sports Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.

Orthopaedic Surgery
|March 13, 2025
PubMed
Summary

The H-Loop technique offers a simpler arthroscopic repair for upper subscapularis tears, significantly improving shoulder function and strength with excellent early tendon integrity. This knotless method enhances range of motion and reduces pain, demonstrating promising clinical and imaging outcomes.

Keywords:
knotlessrotator cuff injuriesrotator cuff repairsubscapularis

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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.