SUBSCAPULAR MUSCLE TRANSPOSITION FOR REPAIR OF CHRONIC ROTATOR CUFF TEARS

  • 1 January 1982
    • journal article
    • research article
    • Vol. 154  (5) , 667-672
Abstract
Subscapularis transposition into a supraspinatus or supraspinatus and infraspinatus rotator cuff defect was overlooked as a method of tendon repair. The surgical technique for this type of repair, with or without the concomitant use of a glenohumeral resurfacing prosthesis, is described. Postoperatively, the extremity is supported in a position that does not allow stress to be placed on the repair until healing has occurred. Physical therapy is begun early and continued for many months. In the present series, satisfactory relief of pain was achieved in 22 of the 26 patients. Active abduction in the plane of the scapula averaged 120 degrees for patients with rotator cuff repair and prosthetic replacement and 130 degrees for those with rotator cuff repair alone. Patients (12) gained more than 30 degrees active abduction, and 4 lost this amount of motion, or greater, as compared with preoperative capabilities. In 2 of the 26 patients, the rotator cuff repair was completely disrupted during the acute postoperative period. Of the 26 patients, 25 were satisfied with the surgical procedure. This type of repair seems to be a secure repair, bringing healthy tendon tissue into an area of tendon degeneration and loss of tissue substance. It satisfies the basic surgical principles of achieving a repair with healthy tissue that is not under tension. The results compare favorably with those reported in the literature on rotator cuff repair and further suggest that this technique is an acceptable alternative for repairing large or massive rotator cuff tears that have tendon substance loss. This technique should not be used for smaller tears, for which more simple techniques are adequate, because if a retear occurs during the postoperative period, the cuff defect might be quite large, with significant pain postoperatively and functional limitations resulting.

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