Abstract
BACKGROUND: The purpose of this study was to compare the clinical outcomes of arthroscopic rotator cuff repair using the muscle advancement (MA) technique in cases with and without subscapularis (SSC) tendon tear. METHODS: The subjects were 31 shoulders of 30 patients who underwent arthroscopic rotator cuff repair with MA for large or massive rotator cuff tears. Among them, 21 shoulders of 20 patients with SSC tear (10 males and 10 females; mean age, 69.4 years) were classified as the T group, and the remaining 10 shoulders without SSC tear were classified as the no subscapularis tendon tear (NT) group (4 males and 6 females; mean age, 69.3 years). The clinical outcomes and cuff integrity of the 2 groups were compared. Clinical outcomes were evaluated using the Japanese Orthopaedic Association score and the Constant Murley score. Fatty degeneration was assessed using the Goutallier classification, and retear was evaluated using the Sugaya classification on magnetic resonance imaging findings. Wilcoxon's signed rank test, Mann-Whitney U-test, and the χ(2) test were used for statistical examination, and a P value of less than .05 was considered a significant difference. The mean post-operative follow-up period was 37.4 months. RESULTS: The mean post-operative Japanese Orthopaedic Association score was 90.5 in the T group and 86.8 in the NT group, and the mean post-operative Constant Murley score was 88.4 in the T group and 82.7 in the NT group. Both groups showed improvement post-operatively, with no significant differences between the 2 groups. The mean post-operative ROM was 152 degrees of flexion, 70 degrees of external rotation, and L1 of internal rotation in the T group, and 145 degrees of flexion, 58 degrees of external rotation, and L2 of internal rotation in the NT group, with no significant differences between the 2 groups. There were no significant differences in the retear rates between the 2 groups: 3 cases (14.3%) in the T group and 2 cases (20%) in the NT group. CONCLUSION: Clinical outcomes of MA were favorable for rotator cuff repair, irrespective of the presence or absence of SSC tears, and there were no significant differences in retear rates between the 2 groups.