Question:From what I've been told by my doctor, I'm pretty sure I have a rotator cuff tear of the subscapularis muscle. The surgeon wants to do an arthroscopic exam. If the scope is positive, then I'll have surgery to repair the problem. Wouldn't it be better to just open up the joint and see what's what?
Answer:More and more surgeons are going with arthroscopic exam and repair at the same time. It is much less invasive than an open operation. With arthroscopic exam, muscles don't have to be cut and the joint capsule is only minimally impacted compared to an open incision procedure.
In the case of the subscapularis muscle, its condition isn't clearly seen during open incision surgery. In fact, the surgeon can get a much better look using arthroscopes with different angles.
A recent study testing shoulders and comparing the results with arthroscopic exam placed subscapularis tears at a much higher prevalence (30 per cent) than previously observed. The authors suggested the higher numbers were a direct result of performing arthroscopic exams.
Arthroscopic exam enables the surgeon to get a good look in and around the shoulder from all sides and from a wide range of angles.Johannes R. H. Barth, MD, et al. The Bear-Hug Test: A New and Sensitive Test for Diagnosing a Scapularis Tear. In The Journal of Arthroscopic and Related Surgery. October 2006. Vol. 22. No. 10. Pp. 1076-1084.
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