Lift-off Test Results After Lesser Tuberosity Osteotomy Versus Subscapularis Peel in Primary Total Shoulder Arthroplasty.
| Autor: | Shafritz AB; From the Department of Orthopaedics and Rehabilitation, University of Vermont Larner College of Medicine, Burlington, VT., Fitzgerald MG, Beynnon BD, DeSarno MJ |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of the American Academy of Orthopaedic Surgeons [J Am Acad Orthop Surg] 2017 Apr; Vol. 25 (4), pp. 304-313. |
| DOI: | 10.5435/JAAOS-D-16-00138 |
| Abstrakt: | Background: The ideal method for management of the subscapularis tendon during anatomic total shoulder arthroplasty (TSA) remains controversial. Methods: In a retrospective cohort study, primary anatomic TSA procedures performed with either a subscapularis peel or a lesser tuberosity osteotomy from 2002 to 2010 were reviewed at a minimum 1-year follow-up. The primary outcome measure was the performance of a normal lift-off test postoperatively. Multivariate logistic regression analysis was performed to determine if other covariates besides surgical technique correlated with an abnormal lift-off test result. Results: Ninety TSA procedures were evaluated. Forty-six procedures were performed with subscapularis peel, and 44 were performed with lesser tuberosity osteotomy. Mean follow-up was 4 years. In the subscapularis peel group, 32 of 46 shoulders (69.6%) had a normal lift-off test, compared with 40 of 44 shoulders (90.9%) in the lesser tuberosity osteotomy group (P = 0.01). The results of multivariate logistic regression suggested that lesser tuberosity osteotomy was associated with a normal postoperative lift-off test 4.5 times more often than was subscapularis peel. Conclusions: Our study suggests that the use of lesser tuberosity osteotomy as the surgical approach for anatomic TSA is a reliable option that provides the patient with a better chance of maintaining subscapularis function postoperatively than the subscapularis peel does. Level of Evidence: Level III retrospective cohort study. |
| Databáze: | MEDLINE |
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