Postoperative Outcomes Are Comparable Between Arthroscopic Subscapularis Repairs Performed With Either All-Suture Anchors or Hard-Body Anchors

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-04-01 DOI:10.1016/j.asmr.2024.101060

Diego Gonzalez-Morgado M.D. , Javier Ardebol M.D. , Ali Ihsan Kilic M.D., Ph.D. , Matthew B. Noble D.O. , Lisa A. Galasso M.D. , Matthew Nugent M.D. , Cameron Phillips M.D. , Patrick J. Denard M.D.

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Abstract

Purpose

To compare clinical outcomes and tendon healing rates of patients undergoing arthroscopic rotator cuff repairs involving the subscapularis (SSC) tendon (isolated or combined) with all-suture anchors (ASAs) versus hard-body anchors (HBAs) and to compare SSC healing rates between these 2 anchors.

Methods

A retrospective comparative study was performed on patients who underwent arthroscopic rotator cuff repair of the SSC with either ASAs or HBAs and had a minimum 2-year follow-up. Range of motion and patient-reported outcomes were collected pre- and postoperatively, including a visual analog scale for pain, American Shoulder and Elbow Surgeons score, and Subjective Shoulder Value. Postoperative strength was measured, including Constant strength and belly press test. SSC healing was evaluated on ultrasounds at the final follow-up.

Results

Eighty-four patients met the study criteria. Twenty-eight underwent SSC repair with ASAs and 56 with HBAs. The mean follow-up for the ASA group and HBA group was 44 ± 22.7 months and 48.4 ± 28.3, respectively (P = .743). Baseline characteristics were comparable between groups (P > .05). Overall, patient-reported outcomes and range of motion showed significant improvements from baseline to the final follow-up in all groups (P < .001). Postoperatively, patients in the ASA group had greater improvement in forward flexion compared to the HBA group: 31° (95% confidence interval, 20°-42°) versus 14° (95% confidence interval, 5°-8°), respectively (P = .002). Postoperative Constant strength was higher in the ASA group compared to the HBA group: 17.5 ± 7.5 versus 13.5 ± 5.6, respectively (P = .04). No statistically significant difference in SSC retear rates was observed between groups: none in the ASA group and 3 (10.7%) in the HBA group (P = .27).

Conclusions

Arthroscopic SSC repair leads to significant functional improvement, with both ASAs and HBAs demonstrating similar low failure rates.

Level of Evidence

Level III, retrospective cohort study.

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关节镜下肩胛下肌修复术后使用全缝线锚钉和硬体锚钉的效果是相似的

目的比较关节镜下肩胛下肌（SSC）肌腱（单独或联合）全缝合锚钉（ASAs）与硬体锚钉（HBAs）的临床疗效和肌腱愈合率，并比较这两种锚钉的SSC愈合率。方法对关节镜下应用asa或HBAs进行SSC肩袖修复的患者进行回顾性比较研究，随访至少2年。术前和术后收集运动范围和患者报告的结果，包括疼痛的视觉模拟量表、美国肩关节外科医生评分和主观肩部值。测量术后肌力，包括恒强度和腹部按压试验。最后随访时超声评估SSC愈合情况。结果84例患者符合研究标准。28例应用asa修复SSC， 56例应用HBAs修复SSC。ASA组和HBA组的平均随访时间分别为44±22.7个月和48.4±28.3个月（P = .743）。各组间基线特征具有可比性(P >；. 05)。总体而言，从基线到最终随访，所有组患者报告的结果和活动范围均有显著改善(P <；措施)。术后，与HBA组相比，ASA组患者的前屈度改善更大：分别为31°（95%可信区间，20°-42°）和14°（95%可信区间，5°-8°）（P = 0.002）。ASA组术后恒强度高于HBA组：分别为17.5±7.5和13.5±5.6 （P = 0.04）。两组间SSC检出率无统计学差异：ASA组无，HBA组3例（10.7%）（P = 0.27）。结论关节镜下SSC修复可显著改善SSC功能，asa和HBAs均表现出相似的低失败率。证据水平：III级，回顾性队列研究。

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