Analysis of the Therapeutic Efficacy of Arthroscopic Repair of the Subscapularis Tendon Combined with Coracoplasty

Abstract Objective: The purpose of this study was to analyze the outcomes of arthroscopic subscapularis tendon repair combined with coracoplasty in the treatment. Methods: The study included 80 patients (46 males, 34 females; age range 33 to 73 years old), they underwent arthroscopic repair for subscapularis tear (typeⅠ，typeⅡ and type Ⅲ) presenting with symptoms of anterior shoulder pain and tenderness. Subcoracoid impingement was defined as a coracohumeral distance of less than 6 mm on the preoperative magnetic resonance image, and the follow-up was at least two years. Patients included two groups: Group A underwent coracoplasty, while Group B did not. The postoperative functional results of the two groups were compared and analyzed. The prognosis of patients was evaluated preoperatively and postoperatively by the University of California Los Angeles (UCLA) shoulder score，American Shoulder and Elbow Surgeons（ASES) shoulder score and Visual Analog Scale（VAS）pain score. Results: Postoperative observations revealed successful primary wound healing among all patients, without any systemic or localized shoulder joint infections or brachial plexus nerve injuries. Both groups exhibited a notable enhancement in overall functional outcomes following surgical intervention. At the 24-month postoperative follow-up, all assessed parameters in both groups showed substantial improvement compared to the preoperative values (P<0.05). The functional scores demonstrated a noteworthy increase in both groups after surgery compared to the preoperative values (p<0.01). When comparing two groups, the p-values for all indicators, except for the forward flexion range of motion, were less than 0.01. The statistical results indicated that patients in Group A had better recovery outcomes than those in Group B, except for forward flexion range of motion. Conclusion: The findings suggested that subcoracoid impingement syndrome could potentially serve as a significant precursor to subscapularis tendon injuries.It is worth noting that the combined approach of subscapularis tendon repair and coracoplasty demonstrated superior therapeutic efficacy compared to isolated subscapularis tendon repair, when subscapularis tendon injuries were associated with subcoracoid impingement.