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Improvement in scapular dyskinesis after rotator cuff repair and subacromial decompression

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To investigate the incidence of scapular dyskinesis (SD) in patients with rotator cuff tears using pre- and postoperative 3D computed tomography, analyze the changes in scapular kinematics that occur after arthroscopic rotator cuff repair, and identify the contributing clinical factors.

Methods

Thirty-five patients (mean age, 62.5 ± 8.4 years) were included. Four scapular angles (upward rotation, internal rotation, protraction, and posterior tilt) were measured. The patients were categorized into three pre-existing SD types according to the difference in measured scapular angles between the affected and unaffected sides (type 1 SD, posterior tilt angle difference <  − 5°; type 2 SD, internal rotation angle difference > 5°; and type 3 SD, upward rotation angle difference > 5°). The prevalence, factors influencing SD, and outcomes were compared between the improved and sustained SD groups.

Results

Twenty three of the 35 patients (65.7%) with rotator cuff tears had SD (type 1, 11; type 2, six; type 3, six). Of the 23 preoperative SD patients, 12 (52.1%) showed improved SD postoperatively. Most of the patients with improved SD (9/12) had type 1 SD (p = 0.021) and a significantly improved posterior tilt angle (p = 0.043). The improvement in SD was correlated with a higher range of motion of forward flexion and higher Constant scores (all p < 0.05). No healing failure occurred in the improved SD group (p = 0.037).

Conclusion

The prevalence of SD was high in patients with degenerative rotator cuff tears. More than half of the SD cases, especially type 1 SD, improved postoperatively. SD recovery correlated with better function and successful rotator cuff healing.

Level of evidence

IV.

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Funding

This paper was supported by Konkuk University in 2019.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Center for Shoulder and Elbow Surgery, Konkuk University, School of Medicine, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 143-729, Korea

    Han Eui Song, Kyung-Soo Oh, Dong Ryun Lee, Samuel Baek & Seok Won Chung

  2. Department of Orthopaedic Surgery, College of Medicine, Kyungpook University, Daegu, Korea

    Jong Pil Yoon

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  1. Han Eui Song
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Contributions

HE Song gathered the data, wrote the initial draft of the manuscript and managed the study. KS Oh designed the study. JP Yoon analysed the data. DR Lee, S Baek conceived the study. SW Chung was involved in the study design, supervision, drafting and revision of the manuscript.

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Correspondence to Seok Won Chung.

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All authors declare no potential conflict of interest.

Ethical approval

IRB No. (KUMC2020-02-021.)

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An informed consent was signed by all patients who were enrolled in this study.

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This study was performed at Konkuk University School of Medicine.

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Song, H.E., Oh, KS., Yoon, J.P. et al. Improvement in scapular dyskinesis after rotator cuff repair and subacromial decompression. Knee Surg Sports Traumatol Arthrosc 29, 3961–3970 (2021). https://doi.org/10.1007/s00167-021-06681-x

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