Soft tissue debridement around the subscapularis tendon and effects on postoperative shoulder joint early range of motion

Purpose: Shoulder joint range of motion (ROM) limitation and pain are the most common clinical conditions and complaints of patients who undergo shoulder arthroscopy. Identifying the possible causes of pain and limitation of the joint motion in the early postoperative period, positively affect both the success of the surgery and patient satisfaction. This study aims to evaluate the effect of soft tissue debridement around the subscapularis muscle tendon on postoperative shoulder ROM. Material and methods: 155 patients who underwent arthroscopic subacromial decompression for subacromial impingement were investigated and after excluded cases, 97 patients were eligible for this study. The patients were divided into two groups. Group 1 included 54 patients who underwent subscapular soft tissue debridement with RF device and Group 2 included 43 patients who were only operated for subacromial impingement. Postoperative shoulder early ROM and pain scores at the third-month follow-up were used. The data were compared to evaluate the effect of debridement of the surrounding soft tissue adhesions around the subscapularis tendon. Results: The patients who underwent arthroscopic subscapular debridement had a better active internal and external rotation range at third-month follow-up as well as the pain score. There was a statistically significant difference between the two groups in terms of early ROM and pain (p=0.001). When the type of adhesion is investigated, it is found that this statistically significant difference is mostly between debridement and non-debridement patients who had synovial hypertrophy (p=0.001). Patients who had a combination of synovial hypertrophy and pulley formation also benefited greatly from debridement like synovial hypertrophy alone. Conclusion: Arthroscopic debridement of soft tissue around the subscapularis tendon showed better early ROM and less pain at postoperative third-month follow-up. We believe that debridement of the contiguous soft tissue with an RF device around the subscapularis tendon during arthroscopic shoulder surgery will most likely improve postoperative results and, therefore, should be added.