Download PDF
CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2019; 60(01): 009-015
DOI: 10.1055/s-0039-1683375
Original Article | Artículo Original
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Estudio comparativo de la distancia coracohumeral en pacientes con patología degenerativa del subescapular y una población voluntaria asintomática

Comparative Analysis of the Coracohumeral Distance between Patients with Degenerative Subscapularis Tendon Pathology and a Normal Age-matched Population
Gabriel Cárdenas
1   Unidad de Cirugía de Hombro, Departamento de Traumatología y Ortopedia, Instituto de Seguridad del Trabajo (IST), Viña del Mar, Chile
2   Fellowship en Cirugía de Hombro, Institut Universitaire Locomoteur et du Sport (iULS), Hôpital Pasteur 2 CHU de Nice, France
,
Christian Calderon
3   Departamento de Imagenología Musculoesquelética, Instituto de Seguridad del Trabajo (IST), Viña del Mar, Chile
,
Tomas Pineda
4   Residente de Traumatología y Ortopedia, Universidad de Chile, Santiago, Chile
,
Joaquin Avila
5   Interno de Medicina, Universidad de Valparaíso, Valparaíso, Chile
,
Ricardo Pefaur
6   Departamento de Bioestadística, Pontificia Universidad Católica de Valparaíso, Chile
› Author Affiliations
Further Information

Publication History

06 November 2018

04 February 2019

Publication Date:
08 March 2019 (online)

   Permissions and Reprints

Resumen

Introducción El pinzamiento subcoracoideo secundario a una distancia coracohumeral (DCH) disminuida, ha sido descrito como una posible etiología de las lesiones degenerativas del tendón del Subescapular (SSC), sin embargo, esa teoría aún es controversial.

Objetivo Evaluar si existe una diferencia significativa entre la DCH promedio de pacientes con patología degenerativa del SSC y un grupo control.

Materiales y Métodos Se diseñó un estudio de casos-controles y se estableció un tamaño muestral mínimo de 36 casos por grupo. De nuestra base de datos, y dentro de un periodo de 6 meses, se rescataron 46 Resonancias Magnéticas (RM) de hombro con patología degenerativa avanzada y/o roturas del SSC (grupo SSC). El grupo control fue conformado por 36 RM realizadas a voluntarios asintomáticos sin patología del mango rotador. Se incluyeron en ambos grupos solo pacientes entre 40 y 60 años. Se utilizó prueba de t para determinar las diferencias entre 2 grupos con un nivel de confianza del 95%.

Resultados La edad promedio del grupo SSC fue 50,1 ± 6,1 años y del grupo control 51,7 ± 6,8 años, no existiendo diferencia estadísticamente significativa entre ambos (p = 0.43). La DCH promedio en el grupo SSC fue 8,58 mm [IC: 7,95–9,21 mm], y en el grupo control fue 11,04 mm [IC: 10,05–12,04 mm]. Al comparar la DCH, se encontró una diferencia estadísticamente significativa entre grupos (p = 0,00048).

Conclusión Nuestros resultados respaldan la existencia de una asociación estadísticamente significativa entre una DCH disminuida y la presencia de patología degenerativa del SSC.

Nivel de Evidencia: III (Estudio de casos y controles).

Abstract

Background The incidence of subscapularis tears is increasing as diagnostic imaging and arthroscopic technology improves. Decreased coracohumeral distance (CHD) with associated Subcoracoid Impingement is thought to be one, potential etiology for these lesions.

Objective The purpose of this study was to identify the association between reduced CHD and degenerative pathology of the subscapularis tendon.

Methods A comparative case-control study was performed. The sample size required to determine significance was calculated to be 36 cases. In total, 46 patients with severe degenerative SSC tendinopathy or subscapularis tears on magnetic resonance imaging (MR) were collected consecutively from our database (SSC group). The control group consisted of 36 asymptomatic volunteers undergoing shoulder MR. Only patients between 40 and 60 years of age were included. An independent t-test was used to determine the statistical significance between the two groups (with a 95% level of confidence).

Results No statistically relevant difference was found between the average age of the two groups (50.1 ± 6.1 and 51.7 ± 6.8; p = 0.43). In the control group, the mean CHD was found to be 11.04 mm [CI:10.05–12.04 mm] and was 8.58 mm [CI: 7.95–9.21 mm] in the subscapularis group. The statistical analysis, comparing the CHD showed a significant difference between groups (p = 0.00048).

Conclusion This study supports the conclusion that degenerative subscapularis pathology is associated with narrowed coracohumeral distance, when compared with an asymptomatic age-matched group.

Level of evidence III (case-control study).

Palabras Claves

distancia coracohumeral - pinzamiento subcoracoideo - estenosis subcoracoidea - subescapular - coracoplastía

Keywords

coracohumeral distance - subcoracoid impingement - subscapularis tear - roller-wringer effect - anterior shoulder pain - subcoracoid stenosis - coracoplasty
 

  • Bibliografía

  • 1 Goldthwait JE. An anatomic and mechanical study of the shoulder joint, explaining many of the cases of painful shoulder, many of the recurrent dislocations and many of the cases of brachial neuralgias or neuritis. J Bone Joint Surg 1909; 2–6 (04) 579-606
    PubMedGoogle Scholar
  • 2 Inman VT, Saunders JB, Abbott LC. Observations on the function of the shoulder joint. J Bone Joint Surg Am 1944; 26 (01) 1-30
    PubMedGoogle Scholar
  • 3 Saha AK. Dynamic stability of the glenohumeral joint. Acta Orthop Scand 1971; 42 (06) 491-505
    CrossrefPubMedGoogle Scholar
  • 4 Lyons RP, Green A. Subscapularis tendon tears. J Am Acad Orthop Surg 2005; 13 (05) 353-363
    CrossrefPubMedGoogle Scholar
  • 5 Lo IK, Burkhart SS. Subscapularis tears: Arthroscopic repair of the forgotten rotator cuff tendon. Tech Shoulder Elbow Surg 2002; 3 (04) 282-291
    CrossrefPubMedGoogle Scholar
  • 6 Lee J, Shukla D, Sánchez-Sotelo J. Subscapularis tears: hidden and forgotten no more. JSES 2018; 74-83 . Doi: 10.1016/j.jses.2017.11.006
    PubMedGoogle Scholar
  • 7 Friedman RJ, Bonutti PM, Genez B. Cine magnetic resonance imaging of the subcoracoid region. Orthopedics 1998; 21 (05) 545-548
    PubMedGoogle Scholar
  • 8 Pfirrmann CW, Zanetti M, Weishaupt D, Gerber C, Hodler J. Subscapularis tendon tears: detection and grading at MR arthrography. Radiology 1999; 213 (03) 709-714
    CrossrefPubMedGoogle Scholar
  • 9 Li X-X, Schweitzer ME, Bifano JA, Lerman J, Manton GL, El-Noueam KI. MR evaluation of subscapularis tears. J Comput Assist Tomogr 1999; 23 (05) 713-717
    CrossrefPubMedGoogle Scholar
  • 10 Morag Y, Jamadar DA, Miller B, Dong Q, Jacobson JA. The subscapularis: anatomy, injury, and imaging. Skeletal Radiol 2011; 40 (03) 255-269
    CrossrefPubMedGoogle Scholar
  • 11 Adams CR, Schoolfield JD, Burkhart SS. Accuracy of preoperative magnetic resonance imaging in predicting a subscapularis tendon tear based on arthroscopy. Arthroscopy 2010; 26 (11) 1427-1433
    CrossrefPubMedGoogle Scholar
  • 12 Adams CR, Brady PC, Koo SS. , et al. A systematic approach for diagnosing subscapularis tendon tears with preoperative magnetic resonance imaging scans. Arthroscopy 2012; 28 (11) 1592-1600 . Doi: 10.1016/j.arthro.2012.04.142
    CrossrefPubMedGoogle Scholar
  • 13 Foad A, Wijdicks CA. The accuracy of magnetic resonance imaging and magnetic resonance arthrogram versus arthroscopy in the diagnosis of subscapularis tendon injury. Arthroscopy 2012; 28 (05) 636-641 . Doi: 10.1016/j.arthro.2011.10.006
    CrossrefPubMedGoogle Scholar
  • 14 Codman EA. The shoulder. 2nd edition. Boston: Thomas Todd Co.; 1934
    Google Scholar
  • 15 Frankle MA, Cofield RH. Rotator cuff tears including the subscapularis. In: Proceedings of the Fifth International Conference on Surgery of the Shoulder. Paris: International Shoulder and Elbow Society. Rosemont (IL): American Academy of Orthopaedic Surgeons; 1992
    PubMedGoogle Scholar
  • 16 Deutsch A, Altchek DW, Veltri DM, Potter HG, Warren RF. Traumatic tears of the subscapularis tendon. Clinical diagnosis, magnetic resonance imaging findings, and operative treatment. Am J Sports Med 1997; 25 (01) 13-22
    CrossrefPubMedGoogle Scholar
  • 17 Sakurai G, Ozaki J, Tomita Y, Kondo T, Tamai S. Incomplete tears of the subscapularis tendon associated with tears of the supraspinatus tendon: cadaveric and clinical studies. J Shoulder Elbow Surg 1998; 7 (05) 510-515
    CrossrefPubMedGoogle Scholar
  • 18 Bennett WF. Subscapularis, medial, and lateral head coracohumeral ligament insertion anatomy. Arthroscopic appearance and incidence of “hidden” rotator interval lesions. Arthroscopy 2001; 17 (02) 173-180
    CrossrefPubMedGoogle Scholar
  • 19 Garavaglia G, Ufenast H, Taverna E. The frequency of subscapularis tears in arthroscopic rotator cuff repairs: A retrospective study comparing magnetic resonance imaging and arthroscopic findings. Int J Shoulder Surg 2011; 5 (04) 90-94
    CrossrefPubMedGoogle Scholar
  • 20 Yoo JC, Rhee YG, Shin SJ. , et al. Subscapularis tendon tear classification based on 3-dimensional anatomic footprint: a cadaveric and prospective clinical observational study. Arthroscopy 2015; 31 (01) 19-28
    CrossrefPubMedGoogle Scholar
  • 21 Lafosse L, Jost B, Reiland Y, Audebert S, Toussaint B, Gobezie R. Structural integrity and clinical outcomes after arthroscopic repair of isolated subscapularis tears. J Bone Joint Surg Am 2007; 89 (06) 1184-1193 . Doi: 10.2106/JBJS.F.00305
    CrossrefPubMedGoogle Scholar
  • 22 Gerber C, Krushell RJ. Isolated rupture of the tendon of the subscapularis muscle. Clinical features in 16 cases. J Bone Joint Surg Br 1991; 73 (03) 389-394
    PubMedGoogle Scholar
  • 23 Gerber C, Hersche O, Farron A. Isolated rupture of the subscapularis tendon. J Bone Joint Surg Am 1996; 78 (07) 1015-1023
    CrossrefPubMedGoogle Scholar
  • 24 Warner JJ, Allen AA, Gerber C. Diagnosis and management of subscapularis tears. Tech Orthop 1994;9(2):116–125°. Tech Orthop 1994; 9 (02) 116-125
    CrossrefPubMedGoogle Scholar
  • 25 Burkhart SS, Tehrany AM. Arthroscopic subscapularis tendon repair: Technique and preliminary results. Arthroscopy 2002; 18 (05) 454-463
    CrossrefPubMedGoogle Scholar
  • 26 Lo IK, Burkhart SS. The comma sign: An arthroscopic guide to the torn subscapularis tendon. Arthroscopy 2003; 19 (03) 334-337 . Doi: 10.1053/jars.2003.50080
    CrossrefPubMedGoogle Scholar
  • 27 Lo IK, Parten PM, Burkhart SS. Combined subcoracoid and subacromial impingement in association with anterosuperior rotator cuff tears: An arthroscopic approach. Arthroscopy 2003; 19 (10) 1068-1078 . Doi: 10.1016/ j.arthro.2003.10.016
    CrossrefPubMedGoogle Scholar
  • 28 Richards DP, Burkhart SS, Lo IK. Subscapularis tears: arthroscopic repair techniques. Orthop Clin North Am 2003; 34 (04) 485-498
    CrossrefPubMedGoogle Scholar
  • 29 Burkhart SS, Brady PC. Arthroscopic subscapularis repair: surgical tips and pearls A to Z. Arthroscopy 2006; 22 (09) 1014-1027
    CrossrefPubMedGoogle Scholar
  • 30 Adams CR, Schoolfield JD, Burkhart SS. The results of arthroscopic subscapularis tendon repairs. Arthroscopy 2008; 24 (12) 1381-1389
    CrossrefPubMedGoogle Scholar
  • 31 Ticker JB, Burkhart SS. Why repair the subscapularis? A logical rationale. Arthroscopy 2011; 27 (08) 1123-1128 . Doi: 10.1016/j.arthro.2011.03.001
    CrossrefPubMedGoogle Scholar
  • 32 Denard PJ, Lädermann A, Burkhart SS. Double-row fixation of upper subscapularis tears with a single suture anchor. Arthroscopy 2011; 27 (08) 1142-1149
    CrossrefPubMedGoogle Scholar
  • 33 Denard PJ, Lädermann A, Burkhart SS. Arthroscopic management of subscapularis tears. Sports Med Arthrosc Rev 2011; 19 (04) 333-341
    CrossrefPubMedGoogle Scholar
  • 34 Lafosse L, Lanz U, Saintmard B, Campens C. Arthroscopic repair of subscapularis tear: Surgical technique and results. Orthop Traumatol Surg Res 2010; 96 (8, Suppl): S99-S108
    CrossrefPubMedGoogle Scholar
  • 35 Edwards TB, Walch G, Sirveaux F. , et al. Repair of tears of the subscapularis. J Bone Joint Surg Am 2005; 87 (04) 725-730
    CrossrefPubMedGoogle Scholar
  • 36 Edwards TB, Walch G, Nové-Josserand L. , et al. Arthroscopic debridement in the treatment of patients with isolated tears of the subscapularis. Arthroscopy 2006; 22 (09) 941-946
    CrossrefPubMedGoogle Scholar
  • 37 Bartl C, Scheibel M, Magosch P, Lichtenberg S, Habermeyer P. Open repair of isolated traumatic subscapularis tendon tears. Am J Sports Med 2011; 39 (03) 490-496
    CrossrefPubMedGoogle Scholar
  • 38 Bennett WF. Arthroscopic repair of isolated subscapularis tears: A prospective cohort with 2- to 4-year follow-up. Arthroscopy 2003; 19 (02) 131-143
    PubMedGoogle Scholar
  • 39 Bennett WF. Arthroscopic repair of anterosuperior (supraspinatus/subscapularis) rotator cuff tears: a prospective cohort with 2- to 4-year follow-up. Classification of biceps subluxation/instability. Arthroscopy 2003; 19 (01) 21-33 . Doi: 10.1053/jars.2003.50023
    PubMedGoogle Scholar
  • 40 Bennett WF. Arthroscopic repair of massive rotator cuff tears: a prospective cohort with 2- to 4-year follow-up. Arthroscopy 2003; 19 (04) 380-390 . Doi: 10.1053/jars.2003.50131
    CrossrefPubMedGoogle Scholar
  • 41 Kim SH, Oh I, Park JS, Shin SK, Jeong WK. Intra-articular repair of an isolated partial articular-surface tear of the subscapularis tendon. Am J Sports Med 2005; 33 (12) 1825-1830
    CrossrefPubMedGoogle Scholar
  • 42 Lucas RM, Iyengar JJ, Ma CB, Feeley BT. Management of subscapularis tears. Tech Shoulder Elbow Surg 2012; 13 (02) 90-100 . Doi: 10.1097/BTE.0b013e31824d61b5
    CrossrefPubMedGoogle Scholar
  • 43 Bartl C, Salzmann GM, Seppel G. , et al. Subscapularis function and structural integrity after arthroscopic repair of isolated subscapularis tears. Am J Sports Med 2011; 39 (06) 1255-1262
    CrossrefPubMedGoogle Scholar
  • 44 Nové-Josserand L, Hardy MB, Leandro Nunes Ogassawara R, Carrillon Y, Godenèche A. Clinical and structural results of arthroscopic repair of isolated subscapularis tear. J Bone Joint Surg Am 2012; 94 (17) e125 [1—6]
    CrossrefPubMedGoogle Scholar
  • 45 Toussaint B, Audebert S, Barth J. , et al; French Arthroscopy Society (SFA). Arthroscopic repair of subscapularis tears: preliminary data from a prospective multicentre study. Orthop Traumatol Surg Res 2012; 98 (8, Suppl) S193-S200 . Doi: 10.1016/j.otsr.2012.10.004
    CrossrefPubMedGoogle Scholar
  • 46 Rhee YG, Lee YS, Park YB, Kim JY, Han KJ, Yoo JC. The outcomes and affecting factors after arthroscopic isolated subscapularis tendon repair. J Shoulder Elbow Surg 2017; 26 (12) 2143-2151
    CrossrefPubMedGoogle Scholar
  • 47 Richards DP, Burkhart SS, Campbell SE. Relation between narrowed coracohumeral distance and subscapularis tears. Arthroscopy 2005; 21 (10) 1223-1228
    CrossrefPubMedGoogle Scholar
  • 48 Bergin D, Parker L, Zoga A, Morrison W. Abnormalities on MRI of the subscapularis tendon in the presence of a full-thickness supraspinatus tendon tear. AJR Am J Roentgenol 2006; 186 (02) 454-459 . Doi: 10.2214/AJR.04.1723
    CrossrefPubMedGoogle Scholar
  • 49 Sein ML, Walton J, Linklater J. , et al. Reliability of MRI assessment of supraspinatus tendinopathy. Br J Sports Med 2007; 41 (08) e9 . Doi: 10.1136/bjsm.2006.034421
    CrossrefPubMedGoogle Scholar
  • 50 Morag Y, Jacobson JA, Miller B, De Maeseneer M, Girish G, Jamadar D. MR imaging of rotator cuff injury: what the clinician needs to know. Radiographics 2006; 26 (04) 1045-1065
    CrossrefPubMedGoogle Scholar
  • 51 Patte D. The subcoracoid impingement. Clin Orthop Relat Res 1990; (254) 55-59
    PubMedGoogle Scholar
  • 52 Dumontier C, Sautet A, Gagey O, Apoil A. Rotator interval lesions and their relation to coracoid impingement syndrome. J Shoulder Elbow Surg 1999; 8 (02) 130-135
    CrossrefPubMedGoogle Scholar
  • 53 Nové-Josserand L, Edwards TB, O'Connor DP, Walch G. The acromiohumeral and coracohumeral intervals are abnormal in rotator cuff tears with muscular fatty degeneration. Clin Orthop Relat Res 2005; (433) 90-96
    PubMedGoogle Scholar
  • 54 MacMahon PJ, Taylor DH, Duke D, Brennan DD, O'Brien J, Eustace SJ. Contribution of full-thickness supraspinatus tendon tears to acquired subcoracoid impingement. Clin Radiol 2007; 62 (06) 556-563
    CrossrefPubMedGoogle Scholar
  • 55 Li X, Fallon J, Egge N. , et al. MRI study of associated shoulder pathology in patients with full-thickness subscapularis tendon tears. Orthopedics 2013; 36 (01) e44-e50
    CrossrefPubMedGoogle Scholar
  • 56 Aktas E, Sahin B, Arikan M. , et al. MRI analysis of coracohumeral interval width and its relation to rotator cuff tear. Eur J Orthop Surg Traumatol 2015; 25 (02) 281-286
    CrossrefPubMedGoogle Scholar
  • 57 Gerber C, Terrier F, Zehnder R, Ganz R. The subcoracoid space. An anatomic study. Clin Orthop Relat Res 1987; (215) 132-138
    PubMedGoogle Scholar
  • 58 Nové-Josserand L, Boulahia A, Levigne C, Noel E, Walch G. [Coraco-humeral space and rotator cuff tears]. Rev Chir Orthop Repar Appar Mot 1999; 85 (07) 677-683
    PubMedGoogle Scholar
  • 59 Tan V, Moore Jr RS, Omarini L, Kneeland JB, Williams Jr GR, Iannotti JP. Magnetic resonance imaging analysis of coracoid morphology and its relation to rotator cuff tears. Am J Orthop 2002; 31 (06) 329-333
    PubMedGoogle Scholar
  • 60 Gerber C, Terrier F, Ganz R. The role of the coracoid process in the chronic impingement syndrome. J Bone Joint Surg Br 1985; 67 (05) 703-708
    PubMedGoogle Scholar
  • 61 Dugarte AJ, Davis RJ, Lynch TS, Schickendantz MS, Farrow LD. Anatomic Study of Subcoracoid Morphology in 418 Shoulders: Potential Implications for Subcoracoid Impingement. Orthop J Sports Med 2017; 5 (10) 2325967117731996
    CrossrefPubMedGoogle Scholar
  • 62 Balke M, Banerjee M, Greshake O, Hoeher J, Bouillon B, Liem D. The Coracohumeral Distance in Shoulders With Traumatic and Degenerative Subscapularis Tendon Tears. Am J Sports Med 2016; 44 (01) 198-201 . Doi: 10.1177/0363546515611653
    CrossrefPubMedGoogle Scholar
  • 63 Lo IKY, Burkhart SS. The etiology and assessment of subscapularis tendon tears: a case for subcoracoid impingement, the roller-wringer effect, and TUFF lesions of the subscapularis. Arthroscopy 2003; 19 (10) 1142-1150 . Doi: 10.1016/j.arthro.2003.10.024
    CrossrefPubMedGoogle Scholar
  • 64 Giaroli EL, Major NM, Lemley DE, Lee J. Coracohumeral interval imaging in subcoracoid impingement syndrome on MRI. AJR Am J Roentgenol 2006; 186 (01) 242-246
    CrossrefPubMedGoogle Scholar
  • 65 Russo R, Togo F. The subcoracoid impingement syndrome: clinical, semeiologic and therapeutic considerations. Ital J Orthop Traumatol 1991; 17 (03) 351-358
    PubMedGoogle Scholar
  • 66 Ferrick MR. Coracoid impingement. A case report and review of the literature. Am J Sports Med 2000; 28 (01) 117-119
    CrossrefPubMedGoogle Scholar
  • 67 Oh JH, Song BW, Choi JA, Lee GY, Kim SH, Kim DH. Measurement of coracohumeral distance in 3 shoulder positions using dynamic ultrasonography: correlation with subscapularis tear. Arthroscopy 2016; 32 (08) 1502-1508
    CrossrefPubMedGoogle Scholar
  • 68 Dines DM, Warren RF, Inglis AE, Pavlov H. The coracoid impingement syndrome. J Bone Joint Surg Br 1990; 72 (02) 314-316
    PubMedGoogle Scholar
  • 69 Suenaga N, Minami A, Kaneda K. Postoperative subcoracoid impingement syndrome in patients with rotator cuff tear. J Shoulder Elbow Surg 2000; 9 (04) 275-278
    CrossrefPubMedGoogle Scholar
  • 70 Kragh Jr JF, Doukas WC, Basamania CJ. Primary coracoid impingement syndrome. Am J Orthop 2004; 33 (05) 229-232 , discussion 232
    PubMedGoogle Scholar
  • 71 Karnaugh RD, Sperling JW, Warren RF. Arthroscopic treatment of coracoid impingement. Arthroscopy 2001; 17 (07) 784-787
    CrossrefPubMedGoogle Scholar
  • 72 Lo IK, Burkhart SS. Arthroscopic coracoplasty through the rotator interval. Arthroscopy 2003; 19 (06) 667-671 . Doi: 10.1016/S0749-8063(03)00219-6
    CrossrefPubMedGoogle Scholar
  • 73 Kleist KD, Freehill MQ, Hamilton L, Buss DD, Fritts H. Computed tomography analysis of the coracoid process and anatomic structures of the shoulder after arthroscopic coracoid decompression: a cadaveric study. J Shoulder Elbow Surg 2007; 16 (02) 245-250
    CrossrefPubMedGoogle Scholar
  • 74 Garofalo R, Conti M, Massazza G, Cesari E, Vinci E, Castagna A. Subcoracoid impingement syndrome: a painful shoulder condition related to different pathologic factors. Musculoskelet Surg 2011; 95 (Suppl. 01) S25-S29
    PubMedGoogle Scholar
  • 75 Stephen S. Burkhart, M.D. ICL 406: Biomechanics and Etiology of Tears of the Subscapularis. 2012 AANA Annual Meeting Orlando, Florida, US
    PubMed
  • 76 Park JY, Lhee SH, Oh KS, Kim NR, Hwang JT. Is arthroscopic coracoplasty necessary in subcoracoid impingement syndrome?. Arthroscopy 2012; 28 (12) 1766-1775
    CrossrefPubMedGoogle Scholar
  • 77 Kim SJ, Choi YR, Jung M, Yoon YK, Chun YM. Concomitant coracoplasty during arthroscopic subscapularis repair does not yield better clinical outcomes and structural integrity. Knee Surg Sports Traumatol Arthrosc 2018; 26 (01) 56-62 . Doi: 10.1007/s00167-016-4368-7
    CrossrefPubMedGoogle Scholar
  • 78 MacDonald P, McRae S, Leiter J, Mascarenhas R, Lapner P. Arthroscopic rotator cuff repair with and without acromioplasty in the treatment of full-thickness rotator cuff tears: a multicenter, randomized controlled trial. J Bone Joint Surg Am 2011; 93 (21) 1953-1960
    CrossrefPubMedGoogle Scholar
  • 79 Shin SJ, Oh JH, Chung SW, Song MH. The efficacy of acromioplasty in the arthroscopic repair of small- to medium-sized rotator cuff tears without acromial spur: prospective comparative study. Arthroscopy 2012; 28 (05) 628-635
    CrossrefPubMedGoogle Scholar