ICJR Interviews: To Repair or Not to Repair’the Subscapularis

    There can be a bit of a catch-22 with reverse shoulder arthroplasty (RSA). To decrease the risk of dislocation, many surgeons repair the subscapularis, as this is thought to increase stability.

    But patients who need an RSA typically have a compromised rotator cuff, and repairing the subscapularis can actually cause deltoid and posterior cuff workload to increase, further compromising cuff function.

    Which begs the question: Is subscapularis repair really necessary…does it really improve outcomes in RSA?

    To find out, Jason Vourazeris, MD, and his colleagues at the University of Florida in Gainesville retrospectively reviewed 6 years of data on more than 200 patients who had undergone primary RSA with a lateralized prosthesis. There were 86 patients in the repair group and 119 patients in the unrepaired group.

    At an average follow-up of 2 years, no differences were seen between the 2 groups in:

    • Functional outcomes scores such as the SPADI, SST-12, and ASES
    • Range or motion, including external rotation, elevation, and abduction
    • Dislocation rates

    Click on the image above to hear Dr. Vourazeris discuss the study, “Comparison of Outcomes of Reverse Total Shoulder Arthroplasty with or without Subscapularis Repair” (Poster 314), which was presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando.

    Producer: Henrik B. Pedersen, MD; Director: Michael Bugera; Post Production: Charles J. Maynard