@article{Chauvet2020-ua,

title = {The invisible MGHL test: Diagnostic value and benefits for the 

 repair of retracted subscapularis tears},

author = {Thomas Chauvet and Emil Haritinian and Florian Baudin and Philippe Collotte and Laurent Nové-Josserand},

year  = {2020},

date = {2020-07-01},

journal = {Am. J. Sports Med.},

volume = {48},

number = {9},

pages = {2144–2150},

publisher = {SAGE Publications},

abstract = {BACKGROUND: Some full-thickness subscapularis tendon tears and 

 partial tears of the deep layer are difficult to characterize, 

 leading to misdiagnosis. PURPOSE: To evaluate the association 

 between displacement of the middle glenohumeral ligament (MGHL) 

 and retracted tears of the subscapularis tendon as a possible 

 test to improve diagnosis. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Videos (N = 100) recorded during 

 arthroscopic rotator cuff repair involving a torn subscapularis 

 tendon were analyzed retrospectively to assess the association 

 between the MGHL test (nonvisibility of the MGHL) and other 

 objective anatomic criteria. The invisible MGHL test was defined 

 as positive if the MGHL was initially nonvisible in the 

 beach-chair position and appeared only when the subscapularis 

 tendon was pulled back into position by using a 30° arthroscope 

 from the standard posterior portal. The parameters considered 

 during the initial exploration were (1) visibility of the 

 horizontal part of the subscapularis tendon; (2) visibility of 

 the MGHL in its usual position, crossing the superior border of 

 the subscapularis tendon; (3) exposure of the lateral border of 

 the subscapularis tendon (full-thickness retracted tear); and 

 (4) complete or partial exposure of the lesser tuberosity of the 

 humerus. Tendon retraction was evaluated in 3 stages according 

 to the Patte classification. RESULTS: The invisible MGHL test 

 result was positive in 45% of cases. It was positive in 6% of 

 cases (2 of 31) when there was no subscapularis tendon 

 retraction and in 62% of cases (43 of 69) when there was 

 partial or complete retraction (P < .001). The invisible MGHL 

 test was significantly associated with the width of the tear (P 

 < .001) and exposure of the lateral border of the subscapularis tendon (full-thickness retracted tea},

keywords = {diagnostic test; middle glenohumeral ligament; retraction;   shoulder; subscapularis; tear},

pubstate = {published},

tppubtype = {article}

}