Thursday, February 14, 2002
The mechanical integrity of subscapularis repair and its function after total shoulder replacement (TSR) has not received enough attention, according to the researchers in poster exhibit 307. Many patients demonstrate loss of terminal internal rotation on physical exam and may complain of functional loss such as the inability to tuck in the back of a shirt after TSR.
Researchers performed a retrospective review of the records of 41 patients who had a TSR between 1995 and 2000 and for whom follow-up of subscapularis function was available. Average follow-up was 1.9 years. Active terminal internal rotation was evaluated by lift off and belly press exams. Functional outcome was determined by the simple shoulder test.
Researchers also recorded the method used to repair the subscapularis. In nine cases, the repair was anatomic; in the remaining 32 cases, the repair was augmented with sutures placed through bone tunnels along the anatomic neck.
Despite meticulous attention to subscapularis repair, suboptimal return of function was demonstrated on clinical exam by positive lift off and belly press and on functional outcome by rating on the simple shoulder test. Twenty-five of 37 (63%) lift off and 24 of 35 (66.6%) belly press exams were abnormal. Twenty-eight of the 41 patients (68.3%) had difficulty tucking a shirt in the back of the pants.
Researchers included Evan L Flatow, MD, Suzanne L Miller, MD, Yassamin Hazrati, MD, and Alexis Chiang, BS, all of New York, NY.
| 2002 Academy News February 14 Index C |
Last modified 08/February/2002