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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2008, Number 4

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Acta Ortop Mex 2008; 22 (4)

Arthroscopic repair of partial subscapularis tendon lesions. Simplified approach

Pagán CA, Sánchez MA, Verdú AC
Full text How to cite this article

Language: Spanish
References: 10
Page: 222-227
PDF size: 192.62 Kb.


Key words:

shoulder, subscapularis tendon, rotator cuff, reconstruction, arthroplasty.

ABSTRACT

We present a technical variation for arthroscopic subscapularis tendon repair. Sutures of isolated partial subscapularis tendon avulsions can be passed and fixed securely through an isolated anterolateral portal just over the rotator interval (mono-tunnel technique). Primarily a shoulder free of fixation devices is needed. Patient on a beach chair position or lateral decubitus without traction is advised. The best view can be obtained from a posterior portal with the shoulder on 75° forward elevation and 90° medial rotation. In a shoulder 30° adducted at a good view can be also obtained from the antero-lateral portal. This working portal alone allows joint and tendon inspection, introduction of round burrs and devices needed for working on bone bed receptor. A titanium anchor of 5 mm with doubled non-absorbable suture is used, it can be passed through tendon with the Artropierce® and an all-inside arthroscopic knot tying is done by just one tunnel thus minimizing the potential of injury of the coracohumeral ligament complex. This technique allows the surgeon to perform subscapularis tendon repair easily with reproducible good results in 7 cases of isolated partial tendon avulsions in this serie. We also recommend it in combination with other rotator cuff repairing techniques.


REFERENCES

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  2. Edwards TB, Walch G, Sirveaux F et al: Repair of tears of the subscapularis: J Bone Joint Surg Am 2006; 88: 1-10.

  3. Bennett WF: Arthroscopic repair of isolated subscapularis tears: A prospective cohort with 2- to 4-year follow-up. Arthroscopy 2003; 19: 131-43.

  4. Bennett WF: Subscapularis, medial and lateral head coracohumeral ligament insertion anatomy: Arthroscopic appearance and incidence of «hidden» rotator interval lesions. Arthroscopy 2001; 17: 173-80.

  5. Wright JM, Heavrin B, Hawkins RJ, Noonan T: Arthroscopic visualization of the subscapularis tendon. Arthroscopy 2001; 17: 677-684.

  6. Constant CR, Murley AHG: A clinical method of functional assessment of the shoulder. Clin Orthop 1987; 214: 160-4.

  7. Gartsman GM, Khan M, Hammerman M: Arthroscopic repair of full-thickness tears of the rotator cuff. J Bone Joint Surg (A) 1998; 80: 832-9.

  8. Kreuz PC, Reminger A, Erggelet C, Hinterwimmer S, Niemeyer P, Gachter A: Isolated and combined tears of the subscapularis tendon. Am J Sport Med 2005; 33(12): 1831-7.

  9. Lo IKY, Burkhart SS: The etiology and assessment of subscapularis tendon tears: a case for subcoracoid impingement, the roller-wringer effect and tuff lesions of the subscapularis. Arthroscopy 2003; 19: 1142-50.

  10. Almazán A, Ruiz M, Cruz F, Pérez FX, Ibarra C: Simple arthroscopic technique for rotator interval closure. Arthroscopy 2006; 22: 230-4.




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Acta Ortop Mex. 2008 Jul-Ago;22