Evaluation of isometric strength and fatty infiltration of the subscapularis in latarjet surgery.

OBJECTIVE: To evaluate the function of the subscapularis muscle by means of isometric strength, clinical examination and analysis of fatty infiltration in patients with recurrent anterior dislocation of the shoulder undergoing Latarjet-Patte surgery. METHODS: 38 patients operated from March 2011 to March 2012, with minimum follow-up of two years were evaluated, being 26 males and 12 females, with a mean age of 28.7 years old. Isometric strength was measured using a portable dynamometer and measuring the distance from the back of the hand during the lift-off test. We used the Rowe and Walch-Duplay scores for clinical evaluation. The degree of fatty infiltration of the subscapularis belly was assessed by computed tomography. RESULTS: The mean scores in the Walch-Duplay and Rowe were 84.7 and 89.4, respectively. The mean distance to the back of the hand was 7.34 cm on the operated side and 8.72 cm on the opposite side (p <0.0001). The mean strength measured in the lift-off test was 0.38 kg lower than on the contralateral side (p = 0.001). There was no fatty infiltration of the subscapularis in 16 patients (42.1%). Sixteen patients (42.1%) were classified as Goutallier grade 1 and six (15.8%) as grade 2. We found that the measured isometric strength decreases with increasing the degree of fatty infiltration (p <0.0001). CONCLUSIONS: The decrease in subscapularis strength, albeit of low magnitude (0.38 kg), was directly related to the degree of fatty infiltration and worse clinical outcomes. Level of Evidence III, Therapeutic Study - Investigating the Results of Treatment.

Avaliação da força isométrica e infiltração gordurosa do subescapular na cirurgia de latarjet / Evaluation of isometric strength and fatty infiltration of the subscapularis in latarjet surgery

Objetivo: Avaliar a função do músculo subescapular por meio da forçaisométrica, do exame clínico e da análise da infiltração gordurosa nospacientes com luxação anterior recidivante do ombro submetidos àcirurgia de Latarjet-Patte. Métodos: Foram avaliados 38 pacientesoperados entre março de 2011 e março de 2012, com seguimentomínimo de dois anos, 26 do gênero masculino e 12 do feminino, comidade média de 28,7 anos. A força isométrica foi aferida utilizando--se um dinamômetro portátil e medindo-se a distância da mão aodorso durante o teste lift-off.

Objective: To evaluate the function of the subscapularis muscle bymeans of isometric strength, clinical examination and analysis offatty infiltration in patients with recurrent anterior dislocation of theshoulder undergoing Latarjet-Patte surgery. Methods: 38 patientsoperated on from March 2011 to March 2012, with minimum follow--up of two years were evaluated, being 26 males and 12 females,with a mean age of 28.7 years old. Isometric strength was measuredusing a portable dynamometer and measuring the distance fromthe back of the hand during the lift-off test.