Abstract
Purpose
Controversy exists regarding the optimal technique of subscapularis mobilization during shoulder arthroplasty. The purpose of this multicentre randomized double-blind study was to compare the functional outcomes and healing rates of the lesser tuberosity osteotomy (LTO) to the subscapularis tenotomy (ST).
Method
Patients undergoing shoulder arthroplasty were randomized to receive either a LTO or ST. The primary outcome was to compare subscapularis strength, as measured by an electronic hand-held dynamometer at 12 months. Secondary outcomes included range of motion, WOOS, Constant and ASES scores. A sample size calculation determined that 80 patients provided 80% power with a 50% effect size to detect a significant difference between groups.
Results
Baseline demographic data did not differ between groups including age (p=0.69), sex (p=0.77), affected side (p=0.59) and arthroplasty type (hemiarthroplasty or total, p=0.77). Strength comparison between groups revealed no statistical differences at any time interval (p=0.744, baseline, p=0.449, 3 month, p=0.203, 6 months, 12 months, p=0.45). Statistically significant improvements occurred in both groups from baseline to 12 month time points in all clinical outcome scores (p<0.0001).
Conclusion
No statistically significant differences in primary or secondary outcomes were identified between the LTO and ST. This trial does not demonstrate any clear advantage of one subscapularis mobilization technique over the other.
