Does partial tear repair of adjacent tendons improve the outcome of supraspinatus tendonfull-thickness tear reinsertion? - 01/10/14

Doi : 10.1016/j.otsr.2014.07.014

C. Nich ^⁎ , N. Dhiaf, M. Di Schino, B. Augereau
Department of Traumatology and Orthopaedic Surgery, Medical school Paris 5 René-Descartes, European Hospital of Paris, Assistance publique–Hôpitaux de Paris, 20-40, rue Leblanc, 75908 Paris cedex 15, France

^⁎Corresponding author. Tel.: +33 1 56 09 32 78; fax: +33 1 56 09 23 96.

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En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 01 October 2014
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Abstract

Background

Partial tearing of the infraspinatus and/or subscapularis tendon(s) is frequently associated with supraspinatus full-thickness tears. However, limited data regarding its influence on supraspinatus surgical repair is available.

Purpose

Our aim was to assess the functional and anatomical outcomes of open repair of supraspinatus full-thickness tears combined with adjacent partial tearing, comparatively to a control.

Methods

We retrospectively identified 22 patients (22 shoulders) with a partial tear, most of them being a delamination tear, of the infraspinatus and/or subscapularis tendons associated with a complete detachment of the supraspinatus tendon. Twenty-seven patients (27 shoulders) treated for an isolated complete detachment of the supraspinatus tendon by open repair served as controls. The mean age was 58 years. A proximalized trans-osseous reinsertion of the supraspinatus tendon was combined with a curettage-closure of the delamination tear. Patients were evaluated with standardized MRI at last follow-up.

Results

At a mean of 75-month follow-up, the presence of a partial tear of either infraspinatus or subscapularis, or both, did not influence function and healing rates of supraspinatus tendon repair. Conversely to the control, when a retear occurred, the functional score tended to worsen. Preoperatively, fatty muscular degeneration was more pronounced when a partial tear was present. Fatty degeneration worsened regardless of repair healing.

Conclusion

Open reinsertion of a supraspinatus full-thickness tear associated with a thorough treatment of partial tear of adjacent tendons led to optimal functional and anatomical mid term outcomes. Our results suggest the presence of a partial tear of adjacent tendons could be associated with poorer function in case of supraspinatus tendon re-rupture.