{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T03:01:55Z","timestamp":1776222115433,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FORE (Foundation for Research and Teaching in Orthopedics, Sports Medicine, Trauma, and Imaging in the Musculoskeletal System)","award":["FORE 2023-55"],"award-info":[{"award-number":["FORE 2023-55"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The importance of the subscapularis tendon in reverse shoulder arthroplasty (RSA) has been increasingly emphasized lately. Recent studies have indicated that a repaired subscapularis tendon has better functional outcomes. This study is aimed at comparing the healing rate of repaired subscapularis tendons between onlay and inlay Bony Increased Offset-Reversed Shoulder Arthroplasty (BIO-RSA). Methods: This retrospective comparative review covers all patients who underwent BIO-RSA at a single center, comprising 189 cases performed by on a single surgeon from January 2012 till December 2021. We included all patients who underwent subscapularis tenotomy repair and who had a tendon ultrasound (US) examination at six months postoperatively (as requested in this single surgeon\u2019s usual protocol). These patients were divided into two comparable groups, an onlay group and an inlay group. Healing status was determined using the Sugaya classification, with healed subscapularis tendons defined as having Sugaya type I\u2013III integrity and the unhealed tendons as having Sugaya type IV and V integrity. Results: In total, 2 patients were excluded because ultrasound was not performed (they missed their appointment); 187 patients were evaluated; 98 patients underwent an onlay BIO-RSA; and 89 patients underwent an inlay BIO-RSA. The healing rate of the repaired subscapularis tendon was 73% in the onlay group and 56% in the inlay one (p = 0.020). Conclusions: The onlay systems may enhance subscapularis tendon healing compared to the inlay one, possibly due to the preserved intramedullary vascularity and the near-normal tendon excursion that can be achieved by the onlay system. Choosing an onlay design can minimize bone cuts during RSA, while achieving good subscapularis tendon healing.<\/jats:p>","DOI":"10.3390\/jcm14020416","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T06:25:54Z","timestamp":1736490354000},"page":"416","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparing Repaired Subscapularis Tendon Integrity Using Ultrasound in Onlay Versus Inlay Reverse Shoulder Arthroplasty"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3637-3461","authenticated-orcid":false,"given":"Shri","family":"Kapilan","sequence":"first","affiliation":[{"name":"CHP Saint Gr\u00e9goire, 6 Boulevard de la Bouti\u00e8re, 35760 Saint-Gr\u00e9goire, France"},{"name":"Institut Locomoteur de l\u2019Ouest (ILO), 35760 Saint-Gr\u00e9goire, France"},{"name":"Department of Orthopedics, Hospital Selayang, Batu Caves 68100, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6709-2139","authenticated-orcid":false,"given":"Marko","family":"Nabergoj","sequence":"additional","affiliation":[{"name":"Valdoltra Orthopaedic Hospital, 6280 Ankaran, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2797-8936","authenticated-orcid":false,"given":"Alexandre","family":"L\u00e4dermann","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics and Trauma Surgery, H\u00f4pital de La Tour, Rue J.-D. Maillard 3, 1217 Meyrin, Switzerland"},{"name":"Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland"},{"name":"Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland"},{"name":"FORE (Foundation for Research and Teaching in Orthopedics, Sports Medicine, Trauma, and Imaging in the Musculoskeletal System), Avenue J.-D. Maillard 3, 1217 Meyrin, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Collin","sequence":"additional","affiliation":[{"name":"CHP Saint Gr\u00e9goire, 6 Boulevard de la Bouti\u00e8re, 35760 Saint-Gr\u00e9goire, France"},{"name":"Institut Locomoteur de l\u2019Ouest (ILO), 35760 Saint-Gr\u00e9goire, France"},{"name":"American Hospital of Paris, 55 boulevard du Ch\u00e2teau, 92200 Neuilly-sur-Seine, France"},{"name":"Clinique Victor Hugo, 5 Bis Rue du D\u00f4me, 75116 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2410","DOI":"10.1016\/j.jse.2022.05.002","article-title":"Inlay versus onlay humeral design for reverse shoulder arthroplasty: A systematic review and meta-analysis","volume":"31","author":"Larose","year":"2022","journal-title":"J. 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Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/2\/416\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:26:30Z","timestamp":1759919190000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/2\/416"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,10]]},"references-count":45,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["jcm14020416"],"URL":"https:\/\/doi.org\/10.3390\/jcm14020416","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,10]]}}}