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Is routine coracoplasty necessary in isolated subscapularis tears?

OBJECTIVES
This study aims to investigate the effect of simultaneous coracoplasty on postoperative clinical outcomes of patients undergoing shoulder arthroscopy due to the tear of the isolated subscapularis.


PATIENTS AND METHODS
The study included 53 patients (16 males, 37 females; mean age 55.8 years; range, 44 to 70 years) who underwent arthroscopic repair for isolated subscapularis tear (type 2 and type 3) with anterior shoulder pain and tenderness. All patients had a coracohumeral distance of less than 7 mm on the preoperative magnetic resonance images and a minimum follow-up period of two years. Patients were divided into two groups as group 1 including patients who underwent coracoplasty and group 2 including those who did not undergo coracoplasty. Patients were evaluated pre- and postoperatively by the University of California Los Angeles (UCLA) shoulder score and the simple shoulder test (SST) score.


RESULTS
There were no significant differences between the groups in terms of age, gender and follow-up time (p>0.05). The preoperative mean UCLA score was 19.65 for group 1 and 20.45 for group 2. The postoperative mean UCLA scores were 27.92 and 29.00, respectively. The preoperative mean SST score was 4.9 for group 1 and 5.1 for group 2. The postoperative mean SST scores were 10.0 and 9.5, respectively. Functional scores increased significantly in both groups postoperatively when compared to the preoperative values (p<0.01). However, there was no statistically significant difference in terms of the increase in UCLA and SST scores between the two groups (p>0.05).


CONCLUSION
We believe that concomitant coracoplasty during arthroscopic repair may not be a necessary routine in the treatment of isolated subscapularis tears.