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The effect of subscapularis tenotomy in athletes operated on for recurrent anterior shoulder dislocation

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Abstract

Purpose

Some authors consider preservation of the subscapularis tendon as one of the most important elements for a successful long-term outcome in patients operated on with open capsulorrhaphy for recurrent anterior shoulder dislocation. The purpose of this study was to evaluate whether vertical tenotomy of the subscapularis tendon might affect internal rotation strength recovery in patients operated on with open capsulorrhaphy for recurrent anterior shoulder dislocation.

Methods

Ninety-six patients were retrospectively followed up at a mean of 72.5 months. They underwent clinical evaluation, Rowe and Walch–Duplay scoring scales, the Visual Analog Scale (VAS), and dynamometric measurements (side-to-side) of internal and external rotation, forward elevation, and abduction. All patients were athletes: 25% were practising risk-free sports, 44% contact sports, 14.5% sports with cocking of the arm, and 14.5% high-risk sports activities.

Results

Five (5.2%) recurrences were registered, and all patients returned to pre-operative sports activity. The Rowe score was 98.12, the Walch–Duplay score 92.25, and the VAS score 0.1. Dynamometric assessment showed no significant differences (side-to-side) in internal rotation (p = 0.34), external rotation (p = 0.9), flexion (p = 0.7), and abduction (p = 0.7). Dominant arms showed better results than non-dominant arms (p < 0.01).

Conclusion

Complete tenotomy of the subscapularis tendon does not seem to negatively affect internal rotation strength recovery or external rotation movement in athletes.

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Authors and Affiliations

  1. Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre, S. Andrea Hospital, University of Rome “La Sapienza”, Via Grottarossa 1035, Rome, RM, Italy

    C. Iorio, R. M. Lanzetti, D. Lupariello, A. Vadalà, M. Fabbri, A. Ciompi, A. Ferretti & A. De Carli

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  1. C. Iorio
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  2. R. M. Lanzetti
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  3. D. Lupariello
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  4. A. Vadalà
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  5. M. Fabbri
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  6. A. Ciompi
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  7. A. Ferretti
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  8. A. De Carli
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Correspondence to D. Lupariello.

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The authors declare that they have no conflict of interest.

Ethical standard

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all patients.

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Iorio, C., Lanzetti, R.M., Lupariello, D. et al. The effect of subscapularis tenotomy in athletes operated on for recurrent anterior shoulder dislocation. Musculoskelet Surg 102, 283–288 (2018). https://doi.org/10.1007/s12306-018-0531-2

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  • DOI: https://doi.org/10.1007/s12306-018-0531-2

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