Arthroscopic Evaluation of the Prevalence of Subscapularis Lesions Associated with Chronic Rotator Cuff Tears
DOI:
https://doi.org/10.63403/re.v33i1.455Keywords:
Supraspinatus, Subscapular, Bicep, Association, ArthroscopyAbstract
Introduction: supraspinatus ruptures represent the most frequent rotator cuff injury. The concomitant involvement of the subscapular has been historically underestimated, especially in partial lesions of the upper third, which can go unnoticed in preoperative imaging studies.
Objectives: to determine the prevalence, injury pattern and association with biceps tendon instability of subscapular ruptures identified by systematic arthroscopic evaluation in patients with chronic supraspinatus rupture.
Materials and methods: retrospective observational study of 100 consecutive patients undergoing shoulder arthroscopy due to chronic supraspinatus rupture between January 2022 and December 2024. Demographic variables, affected side, type of subscapular injury and presence of biceps tendon instability were analyzed. Subscapular lesions were evaluated intraoperatively by systematic arthroscopic inspection.
Results: Subscapular lesions were identified in 34 patients (34%). The most frequent injury was the partial rupture of the upper third (76%), followed by complete rupture of the upper third (12%), compromise of the upper two thirds (9%) and complete rupture of the tendon (3%). Injuries were more frequent in men over 60 years old. Biceps tendon instability was observed in 41% of patients with subscapular injury.
Conclusions: subscapular lesions associated with supraspinatus rupture have a high prevalence when a systematic arthroscopic evaluation is performed. Most correspond to partial lesions of the upper third, frequently associated with pathology of the bicep’s tendon. These findings highlight the importance of careful subscapular inspection during rotator cuff surgery.
Level of evidence: IV. Retrospective Cohort Study
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