Multiple Subscapularis Tendon Sign: A New Risk Factor for Recurrence After Arthroscopic Anterior Shoulder Instability Surgery.
anatomic variation
instability
labrum
shoulder capsule
sports
Journal
Orthopaedic journal of sports medicine
ISSN: 2325-9671
Titre abrégé: Orthop J Sports Med
Pays: United States
ID NLM: 101620522
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
entrez:
6
7
2019
pubmed:
6
7
2019
medline:
6
7
2019
Statut:
epublish
Résumé
Being able to predict recurrence after the treatment of shoulder instability would be helpful in planning the appropriate treatment. To define the multiple subscapularis tendon sign (MSTS) as a novel anatomic variant and a possible risk factor for the recurrence of shoulder instability after anterior stabilization and to evaluate it, together with the other risk factors as described in the literature. Case-control study; Level of evidence, 3. A total of 87 patients met the study criteria and underwent arthroscopic stabilization for anterior shoulder instability. The MSTS was evaluated in this study group. Age, sex, hand dominance, number of preoperative shoulder dislocations, history of overhead or contact sports participation, type of labral lesion, number of anchors used in surgery, presence of the drive-through sign, presence of the MSTS, Oxford Shoulder Score results, and the association of these parameters with recurrence were assessed. The mean follow-up time was 81.0 ± 27.9 months (range, 48-139 months). Nine (10.3%) patients experienced recurrent instability. The presence of the MSTS ( The MSTS is a variation of the anterior shoulder joint capsule. It is a sign of capsular insufficiency or thinning, which may be a risk factor for recurrence after anterior stabilization. Considering the low success rates of anterior capsulolabral repair in patients participating in overhead or contact sports, especially when an ALPSA lesion is present, encountering the MSTS during surgery in this at-risk group may be an indicator for the surgeon to choose the surgical procedure more carefully.
Sections du résumé
BACKGROUND
BACKGROUND
Being able to predict recurrence after the treatment of shoulder instability would be helpful in planning the appropriate treatment.
PURPOSE
OBJECTIVE
To define the multiple subscapularis tendon sign (MSTS) as a novel anatomic variant and a possible risk factor for the recurrence of shoulder instability after anterior stabilization and to evaluate it, together with the other risk factors as described in the literature.
STUDY DESIGN
METHODS
Case-control study; Level of evidence, 3.
METHODS
METHODS
A total of 87 patients met the study criteria and underwent arthroscopic stabilization for anterior shoulder instability. The MSTS was evaluated in this study group. Age, sex, hand dominance, number of preoperative shoulder dislocations, history of overhead or contact sports participation, type of labral lesion, number of anchors used in surgery, presence of the drive-through sign, presence of the MSTS, Oxford Shoulder Score results, and the association of these parameters with recurrence were assessed. The mean follow-up time was 81.0 ± 27.9 months (range, 48-139 months).
RESULTS
RESULTS
Nine (10.3%) patients experienced recurrent instability. The presence of the MSTS (
CONCLUSION
CONCLUSIONS
The MSTS is a variation of the anterior shoulder joint capsule. It is a sign of capsular insufficiency or thinning, which may be a risk factor for recurrence after anterior stabilization. Considering the low success rates of anterior capsulolabral repair in patients participating in overhead or contact sports, especially when an ALPSA lesion is present, encountering the MSTS during surgery in this at-risk group may be an indicator for the surgeon to choose the surgical procedure more carefully.
Identifiants
pubmed: 31276003
doi: 10.1177/2325967119853507
pii: 10.1177_2325967119853507
pmc: PMC6598329
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2325967119853507Déclaration de conflit d'intérêts
The authors declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Références
J Bone Joint Surg Am. 2000 Jan;82(1):35-46
pubmed: 10653082
J Bone Joint Surg Am. 2000 Aug;82(8):1108-14
pubmed: 10954100
Arthroscopy. 2000 Oct;16(7):677-94
pubmed: 11027751
Arthroscopy. 2000 Oct;16(7):740-4
pubmed: 11027759
J Bone Joint Surg Am. 1992 Jun;74(5):713-25
pubmed: 1624486
J Bone Joint Surg Am. 2006 Aug;88(8):1755-63
pubmed: 16882898
J Bone Joint Surg Am. 2006 Nov;88(11):2326-36
pubmed: 17079387
Clin J Sport Med. 2007 Jan;17(1):1-4
pubmed: 17303998
J Bone Joint Surg Am. 2007 Aug;89(8):1665-74
pubmed: 17671003
J Bone Joint Surg Br. 2007 Nov;89(11):1470-7
pubmed: 17998184
J Bone Joint Surg Am. 2008 Apr;90(4):708-21
pubmed: 18381306
J Bone Joint Surg Am. 2008 May;90(5):945-52
pubmed: 18451384
J Bone Joint Surg Am. 2009 Nov;91(11):2537-42
pubmed: 19884424
Am J Sports Med. 2010 Feb;38(2):302-7
pubmed: 20028847
Am J Sports Med. 2010 Sep;38(9):1795-803
pubmed: 20566721
Knee Surg Sports Traumatol Arthrosc. 2011 Sep;19(9):1563-9
pubmed: 21607741
Am J Sports Med. 2011 Nov;39(11):2396-403
pubmed: 21803980
J Shoulder Elbow Surg. 2011 Dec;20(8):1340-50
pubmed: 21831664
Knee Surg Sports Traumatol Arthrosc. 2012 Nov;20(11):2129-38
pubmed: 22836228
J Orthop Surg Res. 2014 Jul 04;9:53
pubmed: 24993404
Br J Sports Med. 2015 Jul;49(14):913-22
pubmed: 25900943
Knee Surg Sports Traumatol Arthrosc. 2016 Feb;24(2):406-13
pubmed: 26377097
Arthroscopy. 2017 Apr;33(4):734-742
pubmed: 27939068
J Bone Joint Surg Am. 2018 Aug 1;100(15):1319-1325
pubmed: 30063594
JSES Open Access. 2018 Mar 01;2(1):74-83
pubmed: 30675571
J Bone Joint Surg Br. 1970 Nov;52(4):704-16
pubmed: 5487570