Transposición del músculo subescapular aumentado para la reparación del rotador

Nobuyuki Tanaka MDa, , , Hisashi Sakahashi MDa, Kazuya Hirose MDa, Takumi Ishima MDa and Seiichi Ishii MDb

aSapporo Gorinbashi Orthopedic Hospital in Gorinbashi Hospitals, Sapporo, Japan bDepartment of Orthopedic Surgery, School of Medicine, Sapporo Medical University, Sapporo, Japan

The effectiveness of rotator cuff repair by augmented subscapularis transposition via the Leeds-Keio artificial ligament was evaluated in patients with rheumatoid arthritis undergoing total shoulder arthroplasty. The minimum follow-up period was 2 years. Final clinical scores (Hospital for Special Surgery scoring system) and the incidence of radiolucency and upward migration of shoulder components in 20 shoulders with rotator cuff repair by augmented subscapularis transposition were superior to those of 19 shoulders with cuff repair by subscapularis transposition alone and similar to those of 22 shoulders with intact rotator cuffs. In shoulders with augmented subscapularis transposition and intact cuffs, clinical scores continued to improve even after the first postoperative year. Our augmented subscapularis transposition did not increase postoperative complications. We conclude that cuff repair by augmented subscapularis transposition is an acceptable alternative for repairing a supraspinatus or supraspinatus and infraspinatus rotator cuff defect in rheumatoid arthritis patients undergoing total shoulder arthroplasty.