Tears in the subscapularis tendon: descriptive analysis and results of surgical repair

Abstract Although not well known, lesions of the subscapularis tendon are more common than usually reported. We conducted a descriptive study of 22 patients (23 shoulders), who underwent surgical repair of subscapularis tendon tears. Mean follow-up was 73 months. The findings were compared to the results of a prospective study published by one of us (R.H.C.), who reviewed 97 other patients (105 shoulders) with a mean follow-up of 13.4 years after surgical repair of a rotator cuff tear. This comparison allowed us to identify the specific features of rotator cuff tears involving the subscapularis tendon. Subscapularis tears were more likely to be related to a shoulder injury and caused more severe functional impairment, as compared to lesions of the other tendons. Time to surgical treatment was shorter when the subscapularis was torn. Subscapularis tears required adaptation of the surgical approach and postoperative protection of external rotation for 4–6 weeks. Outcomes were less satisfactory when the subscapularis tendon was torn. However, the outcomes in both studies were correlated to tear size. The outcomes were often favorable after isolated subscapularis tendon tears and less so when other tendons were involved.