TY - JOUR
T1 - Lesser tuberosity osteotomy versus soft-tissue subscapularis release in Shoulder arthroplasty
T2 - A systematic review
AU - Cagle, Paul J.
AU - Patton, Jason G.
AU - Beck, Ryan T.
AU - Braman, Jonathan
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/5/15
Y1 - 2015/5/15
N2 - Shoulder arthroplasty procedures continued to increase in prevalence, and controversy still remains about the optimal method to manage the subscapularis. Our study reviewed the available literature clinically comparing subscapularis approaches. A systematic review was conducted using MEDLINE, PubMed, and Cochrane Central Register of Controlled Trials. All clinical trials were identified, and trials comparing at least 2 different subscapularis approaches were examined. Six clinical trials were identified comparing lesser tuberosity osteotomy, subscapularis tenotomy, and peel. Two were randomized-controlled trials comparing osteotomy and peel. Both trials demonstrated improvements in both the groups without demonstrating a significant advantage to either approach. Four trials retrospective analyzed subscapularis osteotomy compared with tenotomy. These trials demonstrate a tendency for improved clinical function with subscapularis osteotomy when patients perform a belly-press test or shirt tuck. Level I and II studies have not shown a significant difference between soft-tissue and bony subscapularis approach with shoulder arthroplasty, but retrospective studies have suggested improved clinical outcomes with osteotomy.
AB - Shoulder arthroplasty procedures continued to increase in prevalence, and controversy still remains about the optimal method to manage the subscapularis. Our study reviewed the available literature clinically comparing subscapularis approaches. A systematic review was conducted using MEDLINE, PubMed, and Cochrane Central Register of Controlled Trials. All clinical trials were identified, and trials comparing at least 2 different subscapularis approaches were examined. Six clinical trials were identified comparing lesser tuberosity osteotomy, subscapularis tenotomy, and peel. Two were randomized-controlled trials comparing osteotomy and peel. Both trials demonstrated improvements in both the groups without demonstrating a significant advantage to either approach. Four trials retrospective analyzed subscapularis osteotomy compared with tenotomy. These trials demonstrate a tendency for improved clinical function with subscapularis osteotomy when patients perform a belly-press test or shirt tuck. Level I and II studies have not shown a significant difference between soft-tissue and bony subscapularis approach with shoulder arthroplasty, but retrospective studies have suggested improved clinical outcomes with osteotomy.
KW - Lesser tuberosity osteotomy
KW - Shoulder arthroplasty
KW - Subscapularis
KW - Subscapularis repair
KW - Subscapularis tenotomy
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U2 - 10.1097/BTE.0000000000000050
DO - 10.1097/BTE.0000000000000050
M3 - Article
AN - SCOPUS:84929255905
SN - 1523-9896
VL - 16
SP - 47
EP - 51
JO - Techniques in Shoulder and Elbow Surgery
JF - Techniques in Shoulder and Elbow Surgery
IS - 2
ER -