Is the Subscapularis Function Preserved after the Latarjet Procedure? A Quantitative Analysis Using Positron Emission...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Medical Imaging

Background:

• The Latarjet procedure involves dividing the subscapularis muscle.
• Previous beliefs suggested this split approach preserves internal rotation strength compared to other methods.
• Limited evidence exists on subscapularis function post-Latarjet surgery.

Purpose of the Study:

• To evaluate subscapularis muscle activity after the Latarjet procedure.
• To compare muscle activity at different abduction angles.
• To correlate muscle activity with internal rotation strength.

Main Methods:

• Positron Emission Tomography (PET) with 18F FDG was used to measure subscapularis activity.
• Standardized Uptake Value (SUV) was calculated by fusing PET and CT images.
• Internal rotation strength was assessed using a dynamometer at 0° and 90° abduction.

Main Results:

• Subscapularis SUV was significantly lower on the operated side at 0° abduction compared to the contralateral side (p=0.010).
• No significant difference in SUV was observed at 90° abduction.
• Operated side subscapularis SUV was lower at 0° compared to 90° abduction (p=0.034).
• Internal rotation strength on the involved side was 81.1% of the uninvolved side at 0° abduction.

Conclusions:

• Subscapularis activity is preserved at 90° abduction following the Latarjet procedure with a subscapularis split.
• A 19% reduction in internal rotation strength was observed.
• PET imaging provides insights into muscle function after shoulder surgery.