Symptomatic rotator cuff tears (RCTs) are common and a major contributor to shoulder dysfunction. The subscapularis (SSC) is the only anterior, and the most powerful rotator cuff muscle, making its integrity crucial to balance the forces of the posterior rotator cuff. Often overlooked and underdiagnosed with open rotator cuff surgery, SSC lesions became more recognized with the emergence of arthroscopic shoulder surgery. In fact, the SSC was found to be involved in up to 50% of arthroscopically repaired RCTs. SSC tears most commonly occur in conjunction with supraspinatus tears as anterosuperior RCTs or as massive RCTs. Isolated tears of the SSC are less common, accounting for 3% to 5% of all arthroscopically repaired RCTs.
Outcomes of arthroscopic treatment of isolated SSC tears in the literature are limited. Most outcomes studies have focused on large SSC tears with only a few studies evaluating treatment of the more commonly encountered tears of the upper third of the SSC tendon. Because the upper third of the SSC has the broadest footprint insertion, it has been suggested that the integrity of the upper third SSC is crucial for the SSC function and that these lesions should be repaired rather than debrided. However, little is known about the results of arthroscopic single-anchor repair of partial-thickness and full-thickness tears of the upper third SSC.
The purpose of this study was to investigate outcomes of arthroscopic single-anchor repair and biceps tenodesis of partial-and full-thickness tears of the upper third SSC. It was hypothesized that single-anchor repair of the upper third SSC would result in excellent outcomes, with improved function, decreased pain, and high satisfaction without significant differences between patient-reported outcomes of partial-and full-thickness tears.
