SynthesisArchives of orthopaedic and trauma surgery2022
The role of subscapularis repair following reverse shoulder arthroplasty: systematic review and meta-analysis.
Synthesis in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 34 citations in OpenAlex.
- Subscapularis sparing approach vs. tenotomy of the subscapularis tendon in reverse shoulder arthroplasty: a prospective, randomized, double-blinded clinical trial.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Trial
- Reverse shoulder arthroplasty combined with anterior latissimus dorsi and teres major transfer for restoration of internal rotation in cuff tear arthropathy: a technical note.JSES reviews, reports, and techniques · 2026Article
- Anatomic versus reverse total shoulder replacement with an intact rotator cuff: a comparative musculoskeletal simulation study of glenohumeral joint biomechanics.Arthroplasty (London, England) · 2026Article
- Rotator cuff sparing approach for shoulder arthroplasty.JSES reviews, reports, and techniques · 2026Article
- Article
- Anterior sling with hamstring autograft for recalcitrant reverse shoulder arthroplasty instability.International journal of surgery case reports · 2026Article
- Refining Reverse Shoulder Arthroplasty: From Implant Design to Patient-Specific Strategy.Journal of clinical medicine · 2026Article
- Combined Reverse Total Shoulder Arthroplasty with pectoralis major transfer for rotator cuff arthropathy: technical note.JSES reviews, reports, and techniques · 2025Article
- Clinical outcome of combined reverse total shoulder arthroplasty combined with pectoralis major transfer for rotator cuff arthropathy: a preliminary study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Does glenosphere size impact shoulder rotational range of motion after reverse shoulder arthroplasty? A retrospective cohort study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Risk factors associated with pain while sleeping on the affected shoulder after primary reverse shoulder arthroplasty.Clinics in shoulder and elbow · 2025Article
- Bilateral reverse shoulder arthroplasty: functional outcomes and technical considerations.Clinics in shoulder and elbow · 2025Article
- Testosterone Replacement Therapy Is Not Associated with Greater Revision Rates in Reverse Total Shoulder Arthroplasty.Journal of clinical medicine · 2025Article
- Deltopectoral approach without subscapularis detachment for reverse shoulder arthroplasty. Technique and results of a safe and reproducible subscapularis-sparing approach.JSES reviews, reports, and techniques · 2025Article
- Managing Subscapularis in Shoulder arthroplasty.Journal of clinical orthopaedics and trauma · 2024Article
- Retrospective analysis of the subscapularis-sparing approach for reverse total shoulder arthroplasty.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Clinical outcomes of over-the-top subscapularis repair in reverse shoulder arthroplasty.JSES international · 2024Article
- Influence of lateralized versus medialized reverse shoulder arthroplasty design on external and internal rotation: a systematic review and meta-analysis.Clinics in shoulder and elbow · 2024Article
- Reverse shoulder arthroplasty with a 155° neck-shaft angle inlay implant design without reattachment of the subscapularis tendon results in satisfactory functional internal rotation and no instability: a cohort study.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Article
- Influence of subscapularis tendon reattachment after reverse shoulder arthroplasty: clinical findings and ultrasonographic evaluation of the subscapularis at 89 months mean follow-up.Musculoskeletal surgery · 2023Observational
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeInadequate subscapularis repair has been advocated as one of the contributing factors for dislocation in reverse total shoulder arthroplasty; nonetheless the need to restore the subscapularis tendon integrity is under debate. The aim of this systematic review was to answer the question: does subscapularis reattachment following reverse total shoulder arthroplasty improve joint stability, range of motion and functional scores?
methodsThe literature was systematically screened in accordance with PRISMA guidelines looking for papers evaluating clinical outcomes of reverse total shoulder arthroplasty in relation to the management of subscapularis tendon. Studies comparing clinical outcomes, complications and dislocation rate with or without subscapularis repair were included. Studies in which reverse total shoulder arthroplasty was performed for trauma or tumors were excluded. The methodology of included articles was scored with MINORS scale and the Risk of Bias was assessed adopting the ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) developed by the Cochrane Group. A meta-analysis was also performed combining the studies to increase the sample size and hence the power to obtain meaningful data.
resultsThe database search identified 1062 records, and 6 full-text articles were finally included. A total number of 1085 reverse total shoulder arthroplasty were assessed on. Except for one study, lateralized prosthetic designs have been used. Dislocation occurred in 0.8% (5/599 patients) of the patient with repaired subscapularis and in 1.6% (8/486 patients) of the tenotomized patients, and subscapularis repair was not associated with a higher risk of dislocation (pooled Peto OR: 0.496, 95% CI: 0.163 to 1.510, p = 0.217). Qualitative assessment revealed no differences in the range of motion and clinical scores.
conclusionSubscapularis repair after reverse total shoulder arthroplasty produces no clinically meaningful benefits, particularly using lateralized prosthetic designs. Subscapularis re-attachment does not improve implant stability, nor increases range of motion or clinical scores. Given these results, keeping in mind the antagonistic effect of the repaired subscapularis on external rotation, no evidence lead to suggest subscapularis reattachment following reverse total shoulder arthroplasty with lateralized prosthetic designs.
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