Die isolierte subskapularisruptur: Arthroskopische und offene operationstechnik

P. Minzlaff, C. Bartl, A. B. Imhoff

Publikation: Beitrag in FachzeitschriftArtikelBegutachtung

5 Zitate (Scopus)


Objective. Arthroscopic or open reconstruction of isolated subscapularis tendon tears with the use of suture anchors to restore the glenohumeral function and joint biomechanics.Indications. Traumatic full-thickness tears, chronic tears with a functional deficit or decentration of the humerus head, anterosuperior rotator cuff insufficiency, symptomatic rerupturesafter prior arthroscopic or open surgical procedures.Contraindications. Frozen shoulder, atrophy > grade II (Thomazeau) or fatty infiltration > grade III (Goutallier/Fox) of the muscle, high-grade omarthrosis.Surgical Technique. Diagnostic arthroscopy and careful tendon release. If the inferior edge of the rupture is reliable visible and the tendon-mobilisation works proper, the repair is performed arthroscopically. The footprint is decorticated lightly and 1-4 suture anchors (depending on the lesion-size) are placed from inferior to superior. Knots are tied starting from caudal in a modified Mason-Allen technique (alternative: single or double mattress stitches) with a slipknot and three half hitches in opposite directions.In case of larger tears, a double-row technique for better reconstruction of the trapezoidal footprint is performed. For open reconstruction, a deltopectoral approach is used to reattache the tendon in an analogous fashion.Results. Arthroscopic or open repair of isolated subscapularis tendon tears (Fox type II-IV) was performed in 35 patients. The Constant score increased significantly after 36 m, with no difference between these two groups. The majority of subscapularis tests were postoperatively negative, 6% in both groups showed a rerupture. A symptomatic period of >6 m prior to the operation and a high grade atrophy and fatty infiltration of the muscle was correlated with poorer results.

Titel in ÜbersetzungThe isolated subscapularis tendon tear. Arthroscopic and open repair
Seiten (von - bis)468-478
FachzeitschriftOperative Orthopadie und Traumatologie
PublikationsstatusVeröffentlicht - Nov. 2012
Extern publiziertJa


  • Arthroscopic surgery
  • Rotator cuff
  • Subscapularis rupture
  • Suture techniques
  • Tendon injuries


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