This study reports that there was ultrasound evidence of partial failure of the subscapularis in 7 of 23 shoulders having a transosseous repair of the subscapularis using 3-5 sutures. There were no significant differences in pain, activities of daily living, range of motion, strength, Constant score or ASES score between the partial tear and the intact groups.
We continue to prefer to detach the subscapularis from the lesser tuberosity, keeping the capsule intact on its deep surface to enable a strong transosseous repair with six sutures of number 2 Tevdek. This approach allows us to resect osteophytes at the lesser tuberosity, giving us optimal access to the glenoid without risking the integrity of the humeral metaphysis. At the conclusion of the procedure, we measure the range of external rotation that can be easily achieved without tension on the repair.
Postoperatively, it is critical to protect the repair while implementing early flexion as shown here.
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