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• W3207652786 abstract "Subscapularis management during total shoulder arthroplasty (TSA) remains an area of debate. Although subscapularis-sparing techniques exist, most TSAs are performed through a deltopectoral interval with the subscapularis released and repaired. A paucity of literature exists comparing transosseous repair (TOR) with direct primary tendon repair (PTR) of a subscapularis tenotomy. Our study compared outcomes after TOR and PTR in patients undergoing anatomic TSA. This retrospective study included patients who underwent primary anatomic TSA through a deltopectoral approach with subscapularis tenotomy using either PTR or TOR for repair. Outcome measures included subscapularis failure rates, visual analog scale (VAS) scores, American Shoulder and Elbow Surgeons (ASES) survey scores, internal rotation range of motion and strength, complications, and reoperation rates at 3 months, 1 year, and 2 years. Institutional database query identified 306 patients who had primary anatomic TSA, 114 of whom had PTR and 192 TOR. Postoperative ASES and VAS scores were significantly improved at all time points in both groups compared with the preoperative scores (P < .001). Average active internal rotation was significantly improved at all time points in the PTR group (P < .001). In the TOR group, significant improvement was noted at 1 and 2 years but not at 3 months. Overall, subscapularis failure occurred in 13 patients, and complications that did not require surgery were noted in 28 patients. Reoperation was performed in 18 patients. However, subscapularis failures, complications not requiring surgery, and reoperations were not significantly different between the two groups. The difference in average internal rotation range of motion between the TOR and PTR groups was statistically significant at 3 months (P = .015) but not at 1 year (P = .265), although the difference trended toward significance again at the 2-year mark (P = .080). No significant differences were noted between the two groups in internal rotation strength, VAS scores, and ASES averages. Both transosseous and primary soft-tissue repair techniques after subscapularis tenotomy result in good outcomes after primary anatomic TSA. No differences were found between groups regarding clinical subscapularis failure rate, internal rotation range of motion or strength, VAS, or ASES scores at 2-year follow-up. Level III, Retrospective Comparative Study" @default.
• W3207652786 created "2021-10-25" @default.
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• W3207652786 date "2021-10-01" @default.
• W3207652786 modified "2023-10-01" @default.
• W3207652786 title "Failure rates and outcomes after anatomic total shoulder arthroplasty are equivalent irrespective of subscapularis repair technique" @default.
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• W3207652786 doi "https://doi.org/10.1053/j.sart.2021.08.002" @default.
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