Subscapularis tendon tears: Management and arthroscopic repair
| Autor: | Brett A. Lenart, Jonathan B. Ticker |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Shoulder medicine.medical_treatment Tenotomy Physical examination Arthroscopic Rotator Cuff Repair Biceps 03 medical and health sciences 0302 clinical medicine Subscapularis medicine Orthopedics and Sports Medicine Arthroscopic Subscapularis Repair Contraindication 030222 orthopedics Rehabilitation medicine.diagnostic_test business.industry Shoulder & Elbow 030229 sport sciences Subscapularis tendon Rotator Cuff Tear Tendon Surgery medicine.anatomical_structure Tears business |
| Zdroj: | EFORT Open Reviews |
| ISSN: | 2058-5241 |
| Popis: | Tears of the subscapularis tendon have been under-recognised until recently. Therefore, a high index of suspicion is essential for diagnosis. A directed physical examination, including the lift-off, belly-press and increased passive external rotation can help identify tears of the subscapularis. All planes on MR imaging should be carefully evaluated to identify tears of the subscapularis, retraction, atrophy and biceps pathology. Due to the tendency of the tendon to retract medially, acute and traumatic full-thickness tears should be repaired. Chronic tears without significant degeneration should be considered for repair if no contraindication exists. Arthroscopic repair can be performed using a 30-degree arthroscope and a laterally-based single row repair; one anchor for full thickness tears ⩽ 50% of tendon length and two anchors for those ⩾ 50% of tendon length. Biceps pathology, which is invariably present, should be addressed by tenotomy or tenodesis. Timing of post-operative rehabilitation is dictated by the size of the repair and the security of the repair construct. The stages of rehabilitation typically involve a period of immobilisation followed by range of movement exercises, with a delay in active internal rotation (IR) and strengthening in IR.Cite this article: EFORT Open Rev 2017;2:484–495. DOI: 10.1302/2058-5241.2.170015 |
| Databáze: | OpenAIRE |
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