Blinded Ultrasound Examination of the Subscapularis Following Anatomic Shoulder Arthroplasty.
Shoulder arthroplasty
hemiarthroplasty
rotator cuff
shoulder osteoarthritis
subscapularis
total shoulder arthroplasty
ultrasound
Journal
Journal of shoulder and elbow arthroplasty
ISSN: 2471-5492
Titre abrégé: J Shoulder Elb Arthroplast
Pays: United States
ID NLM: 101763114
Informations de publication
Date de publication:
2019
2019
Historique:
received:
10
08
2018
revised:
21
11
2018
accepted:
24
01
2019
entrez:
9
9
2021
pubmed:
25
2
2019
medline:
25
2
2019
Statut:
epublish
Résumé
The subscapularis tendon is commonly released during shoulder arthroplasty, and its integrity and repair postoperatively have been shown important to help maximize patient function. However, diagnosing subscapular tendon failure can be difficult with magnetic resonance imaging secondary to metal artifact as well as very costly. The purpose of this study was to assess the utility of ultrasound imaging in evaluating subscapularis integrity at specific time points following shoulder arthroplasty, in a blinded fashion. Secondarily, we report on the correlation between the condition of the subscapularis and quality-of-life outcome measures. Prospective case series. Ultrasounds were completed preoperatively and postoperatively at 1 week as well as at 1, 3, and 6 months. Each was read by a single musculoskeletal radiologist and categorized as "intact," "torn," or "unclear." Clinical outcome was evaluated using the Western Ontario Osteoarthritis Shoulder (WOOS) index at these same time points. The final study group consisted of 35 procedures in 33 patients (19 females and 14 males, mean age 66 ± 9 years). Three patients had postoperative subscapularis failures that were confirmed in the operating room at the time of repair. Of 24 sonographs categorized as "unclear" in the postoperative period, the majority (n = 12, 50%) were taken at 1 week. Compared to preoperative scores, patients had lower WOOS scores at 1, 3, and 6 months postoperatively ( The utility of ultrasound examination of the subscapularis tendon following shoulder arthroplasty is limited by timing and may be most useful when used by the physician within clinical context. Significant improvement was noted in disease-specific quality-of-life scores regardless of the status of the subscapularis tendon as read on ultrasound.
Sections du résumé
BACKGROUND
BACKGROUND
The subscapularis tendon is commonly released during shoulder arthroplasty, and its integrity and repair postoperatively have been shown important to help maximize patient function. However, diagnosing subscapular tendon failure can be difficult with magnetic resonance imaging secondary to metal artifact as well as very costly.
PURPOSE
OBJECTIVE
The purpose of this study was to assess the utility of ultrasound imaging in evaluating subscapularis integrity at specific time points following shoulder arthroplasty, in a blinded fashion. Secondarily, we report on the correlation between the condition of the subscapularis and quality-of-life outcome measures.
STUDY DESIGN
METHODS
Prospective case series.
METHODS
METHODS
Ultrasounds were completed preoperatively and postoperatively at 1 week as well as at 1, 3, and 6 months. Each was read by a single musculoskeletal radiologist and categorized as "intact," "torn," or "unclear." Clinical outcome was evaluated using the Western Ontario Osteoarthritis Shoulder (WOOS) index at these same time points.
RESULTS
RESULTS
The final study group consisted of 35 procedures in 33 patients (19 females and 14 males, mean age 66 ± 9 years). Three patients had postoperative subscapularis failures that were confirmed in the operating room at the time of repair. Of 24 sonographs categorized as "unclear" in the postoperative period, the majority (n = 12, 50%) were taken at 1 week. Compared to preoperative scores, patients had lower WOOS scores at 1, 3, and 6 months postoperatively (
CONCLUSION
CONCLUSIONS
The utility of ultrasound examination of the subscapularis tendon following shoulder arthroplasty is limited by timing and may be most useful when used by the physician within clinical context. Significant improvement was noted in disease-specific quality-of-life scores regardless of the status of the subscapularis tendon as read on ultrasound.
Identifiants
pubmed: 34497946
doi: 10.1177/2471549219832442
pii: 10.1177_2471549219832442
pmc: PMC8282130
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2471549219832442Informations de copyright
© The Author(s) 2019.
Déclaration de conflit d'intérêts
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Augustus D. Mazzocca is a paid consultant for Arthrex Inc. as well as receives research laboratory support funding from Arthrex Inc.
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