Subscapularis release in shoulder replacement determines structural muscular changes.

Clinical Orthopaedics and Related Research
Lieven Franciscus De WildeBart M Berghs

Abstract

Osteotomy of the lesser tuberosity in shoulder arthroplasty allows bony healing of the subscapularis tendon but does not prevent fatty degeneration in its muscle. Occurrence or increase in fatty degeneration may depend on the surgical technique. We (1) assessed fatty degeneration in the subscapularis muscle and its cross-sectional area after a C-block osteotomy of the lesser tuberosity with minimal mobilization of the subscapularis muscle, and (2) determined whether this technique had any adverse effect on function, fatty degeneration, and cross-sectional area of the subscapularis muscle. We retrospectively examined 36 patients with shoulder replacements who had C-block osteotomies. Constant-Murley scores and clinical signs of subscapularis insufficiency were recorded. We radiographically assessed prosthetic placement. On CT scans, lesser tuberosity healing, fatty degeneration, and cross-sectional area of the subscapularis muscle were determined. The minimum followup was 13 months (mean, 18 months; range, 13-33 months). The mean absolute Constant-Murley score was 71.2. Two patients had weakness of the subscapularis muscle without loss of active motion. All tuberosities healed anatomically. A normal glenohumeral relationship was...Continue Reading

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Citations

Dec 18, 2013·Journal of Shoulder and Elbow Surgery·Iwein PiepersLieven De Wilde
Jan 7, 2014·Current Reviews in Musculoskeletal Medicine·Maike Mueller, Gregory Hoy
Apr 27, 2013·Journal of Shoulder and Elbow Surgery·Lieven De WildeAlexander Van Tongel
Jan 22, 2013·Clinical Biomechanics·A TerrierA Farron
Jul 14, 2016·Expert Review of Medical Devices·Anne KarelseL De Wilde
Jan 24, 2017·Journal of Shoulder and Elbow Surgery·Edward ShieldsJ Michael Wiater

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