University of Cote d'Azur, France
ScientificTracks Abstracts: J.Orthop.Trauma Surg.Relat.Res.
Statement of Problem: Despite significant evolution in our knowledge regarding the diagnosis and management of degenerative subscapularis (SSC) tendon tears in the last years, its pathogenesis still remains unclear. The purpose of this study was to try and find the existence of an association, or not, between a narrowed Coracohumeral Distance (CHD) and degenerative pathology of the SSC tendon. We hypothesize that a diminished CHD is associated with an increased prevalence of degenerative SSC tendon pathology, as has been proposed by Lo and Burkhart.
Methodology & Theoretical Orientation: We analysed all available literature that relates the CHD and SSC degenerative pathology, in order to find any association between these variables. Level of Evidence and potential therapeutic implications of these findings were also analysed. Findings: Several studies that support a statistically relevant association between degenerative SSC pathology and a narrowed CHD exist. However, there are no studies demonstrating a linear correlation between theses variables that allow a major causal relationship to be established. Moreover, the clinical implication of this association is not clear in the current literature.
Conclusion & Significance: Despite our hypothesis being proven by clinical studies supporting a statistically significant association between subcoracoid stenosis (narrowed CHD) and chronic degenerative SSC tears, the level of evidence of these studies remains limited. Additionally, the therapeutic implications of this association remain unclear. The shoulder surgeon should be aware of these findings and understand the need for higher level evidence before changing their surgical behaviour.
Gabriel Cárdenas has expertise in the evaluation and management of shoulder pathology. He has served as the head of shoulder arthroscopy, trauma and reconstruction unit of the Chilean Institute of work safety (Instituto de Seguridad del Trabajo, IST). He currently is completing a year-long fellowship at the University Institute of Locomotion and Sport, Pasteur 2 Hospital in Nice, France, under the guidance of Professor Pascal Boileau