Management of the subscapularis in open shoulder surgery is a controversial topic. Subscapularis tenotomy has been the traditional approach, but other techniques have recently been developed to preserve the integrity of the subscapularis tendon. These include subscapularis peel, subscapularis split, and lesser tuberosity osteotomy. The biologic healing and biomechanical properties associated with each surgical approach must be evaluated to determine the best option for each patient. A strong, anatomic repair is required to achieve optimal clinical outcomes.
From Shoulder Service, Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY (Dr. DeFranco), Harvard Shoulder Service, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA (Dr. Higgins), and Harvard Shoulder Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston (Dr. Warner).
Dr. Higgins or an immediate family member has received royalties from Zimmer and is a member of a speakers' bureau or has made paid presentations on behalf of and serves as a paid consultant to or is an employee of Johnson & Johnson. Dr. Warner or an immediate family member has received royalties from Zimmer and has received research or institutional support from Aircast, Arthrex, Mitek, Smith & Nephew, and ArthroCare. Neither Dr. DeFranco nor any immediate family member has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.