Single double-loaded anchor repair of isolated Lafosse III subscapularis tears in patients not involved in physically demanding activities provides satisfactory functional and radiologic outcomes at minimum 5-year follow-up

Abstract

To evaluate the outcomes of single-anchor repair for isolated Lafosse III subscapularis tears in patients not engaged in physically demanding activities. Patients with isolated subscapularis tears who underwent arthroscopic surgery between 2014 and 2020 were retrospectively evaluated. The inclusion criteria were patients who underwent single double-loaded anchor repair for Lafosse III tears and were not involved in physically demanding activities. Assessments included the American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley Score (CMS), Visual Analog Scale (VAS), range of motion, specific clinical tests, and magnetic resonance imaging encompassing tendon integrity, cross-sectional area (CSA), vertical diameter, and transverse diameters. 27 patients (mean age 52.4 ± 10.3 years; mean follow-up 80.8 ± 18.6 months) were included in the study. The final follow-up demonstrated significant improvements in the ASES (44.0 ± 12.4 to 82.4 ± 14.1), CMS (49.1 ± 15.3 to 85.3 ± 11.1), VAS (5.7 ± 2.1 to 1.3 ± 2.2), and internal rotation (L4 to T8) (p < 0.001 for all). The positivity of clinical tests decreased substantially: Bear-Hug, from 93% to 18%; Belly-Press, from 89% to 15%; and Lift-Off, from 89% to 18% (p < 0.001 for all). Radiological analyses indicated maintained tendon integrity in 93% of patients and increases in CSA (1.292 ± 453 to 1.544 ± 609 mm²) and vertical diameter (72.2 ± 11.9 to 82.2 ± 15.3 mm) (p < 0.001 for both). Single double-loaded anchor repair provides satisfactory functional recovery and tendon integrity after five years in patients with isolated Lafosse III subscapularis tears who are not involved in physically demanding activities. These findings suggest using a single anchor offers surgeons a reliable method that combines technical simplicity with durable clinical success in patients without high functional demands. Level IV, therapeutic study, retrospective case series.