Clinical outcomes of arthroscopic suture-bridge repair for rotator cuff with subscapularis tendon tear

In subscapularis (SSC) tendon tears, secure repair is crucial for maintaining the transverse force couple. The purpose of this study was to analyze the outcomes of the suture-bridge (SB) technique in arthroscopic rotator cuff repair (ARCR) for isolated SSC tears and for SSC tears accompanying other parts of rotator cuff tears.

Subjects were 53 shoulders of 52 patients who underwent ARCR for SSC tendon tears by the SB technique between September 2011 and April 2022, either having an isolated SSC tear (7 shoulders) or an SSC tear combined with other rotator cuff tears (46 shoulders). The mean postoperative follow-up period was 30.6 months. Pre and postoperative evaluations included range of motion (ROM), the Japan Orthopaedic Association scores, the University of California at Los Angeles (UCLA) scores, global fatty degeneration index, and tendon integrity according to the Sugaya classification based on magnetic resonance imaging findings.

The median ROM significantly improved in all cases. The median Japan Orthopaedic Association scores significantly improved from 60 points to 91 points. The UCLA scores also significantly improved from 12 points to 31 points. The mean preoperative global fatty degeneration index was 1.4 (range: 1-3). One shoulder (1.9%) had a retear of the SSC, and 6 shoulders (11.3%) had a retear of other rotator cuff tendons. A comparison of the retear and nonretear groups showed significant ROM differences in preoperative flexion, abduction, and external rotation.

ARCR with the SB technique for SSC tears is considered to provide good clinical outcomes, though preoperative limitation of the shoulder ROM is a risk factor for retear.