REVIEW   

Minerva Ortopedica e Traumatologica 2017 September;68(3):168-78

DOI: 10.23736/S0394-3410.17.03824-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Subscapularis tendon management during anatomic and reverse total shoulder arthroplasty

Edward J. SHIELDS, J. Michael WIATER ✉

Department of Orthopedic Surgery, Beaumont Health Hospital, Royal Oak, MI, USA

Even though the yearly incidence of total shoulder arthroplasty procedures continues to rise, controversy remains regarding the best techniques for management of the subscapularis (SSc) tendon during both anatomic total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA). For ATSA, the SSc tendon can be managed with a tenotomy, peel, lesser tuberosity osteotomy, or subscapularis sparing techniques. Failure of the SSc to heal may predispose these patients to more pain, weakness, and instability. During RTSA, some choose to repair the tendon to maximize joint stability and internal rotation strength, while others leave it unrepaired to decrease risk of stiffness. This review discusses the anatomy, various SSc take down and repair techniques, along with biomechanical and clinical data regarding SSc management for ATSA and RTSA.

KEY WORDS: Arthroplasty, replacement, shoulder - Subscapularis management - Osteotomy - Tenotomy