This prospective study tracked 3D shoulder kinematics before and at least 12 months after arthroscopic repair of isolated supraspinatus tears. Using wearable inertial sensors, it asked whether restoring the tendon also restores normal scapulohumeral rhythm. The cohort was 21 patients compared against 21 healthy controls.
The clinical lesson: a healed cuff and a good Constant score do not mean the shoulder moves normally. Scapular dyskinesis that was present before surgery was still measurable 12 months later, even though every repair was intact and pain, strength, and elevation all improved.
The authors frame this as fixed neuromuscular compensation. Serratus anterior delay, trapezius weakness, and scapular substitution develop while the cuff is torn and are not reversed by tendon repair alone. For a trainee, this reframes postoperative rehab. Strengthening the cuff is not enough. Protocols should specifically address scapular control, proprioception, and motor retraining.
Keep the appraisal honest: this is a Level IV case series of 21 patients at only 12 months, and nearly half had biceps tenotomy, so it flags a problem rather than proving a rehab solution.
This prospective study tracked 3D shoulder kinematics before and at least 12 months after arthroscopic repair of isolated supraspinatus tears. Using wearable inertial sensors, it asked whether restoring the tendon also restores normal scapulohumeral rhythm. The cohort was 21 patients compared against 21 healthy controls.
The clinical lesson: a healed cuff and a good Constant score do not mean the shoulder moves normally. Scapular dyskinesis that was present before surgery was still measurable 12 months later, even though every repair was intact and pain, strength, and elevation all improved.
The authors frame this as fixed neuromuscular compensation. Serratus anterior delay, trapezius weakness, and scapular substitution develop while the cuff is torn and are not reversed by tendon repair alone. For a trainee, this reframes postoperative rehab. Strengthening the cuff is not enough. Protocols should specifically address scapular control, proprioception, and motor retraining.
Keep the appraisal honest: this is a Level IV case series of 21 patients at only 12 months, and nearly half had biceps tenotomy, so it flags a problem rather than proving a rehab solution.