IS THE PRESENCE OF SUBSCAPULARIS TEAR WITH SUPRASPINATUS TEAR RELATED TO SCAPULAR MORPHOLOGY?

ABSTRACT
Aim: In previous studies it has been shown that scapular morphology is associated with supraspinatus tears. However, the relationship between subscapularis tears and scapular morphology is controversial. The aim of this study is to investigate whether or not subscapularis tear accompying supraspinatus tear is related to scapular morphology.
Materials and Method: Records and imaging of 679 shoulder arthroscopy surgeries performed for rotator cuff tear in our orthopedics and traumatology clinic between 2016 and 2020 were retrospectively analyzed. 162 patients with isolated full-thickness supraspinatus tear and 83 patients with subscapularis tear accompanying supraspinatus tear were included in the study. The critical shoulder angle (CSA), glenoid version (GV), glenoid inclination (GI) and critical coracoid process angle (CCPA) of the patients were measured.
Results: In the patient group with isolated supraspinatus tear and in the group with subscapularis tear accompanying supraspinatus tear; The mean age was 53.8±8.9 and 61.1±8.4 respectively, and there was a significant difference (P<0.001); the mean CSA values were 36.9º±4.25º and 35.6º±5.1ºrespectively, (P=0.32); GI mean values were 7.72º±5.4º and 8.4º±5.3ºrespectively, (P=0.51); GV mean values were 2.1º±4,5º and 2.5º±4.7º respectively,(P = 0.85); mean CCPA values were 21.4º±4.5º and 22.3º±4.9ºrespectively, (P=0.73). There was no significant difference between the groups in terms of gender (P=0.59). In the logistic regression analysis performed by using criteria of the measured angles, age and gender, it was observed that advanced age had an effect on the subscapularis tear accompanying the supraspinatus tear, independent of the other parameters (P < 0.001 OR:1.09).
Conclusion: There appears not to be a significant difference between isolated supraspinatus tears and subscapularis tear accompanying supraspinatus tear, in terms of radiological parameters regarding scapular morphology. Age seems to be the most important factor in subscapularis tear accompanying supraspinatus tears. In patients with supraspinatus tear, an increase in age by one unit (in years) increases the odds of subscapularistear by1.09 times.
Keywords: Supraspinatus, subscapularis, scapular morphology