Tecniche chirurgiche artroscopiche per la riparazione delle lesioni del sottoscapolare

摘要

Arthroscopic repair of the subscapularis tendon has been introduced later than arthroscopic repair of the rotator cuff because of technical difficulties and lack of anatomical knowledge of this tendon, the so-called “forgotten tendon”. The anatomic repair of this tendon is functional to maintain proper biomechanics of the shoulder. A careful evaluation of the patient, both with clinical tests and instrumental examinations, is mandatory prior to approaching arthroscopic evaluation. During arthroscopy possible and frequent biceps pathologies should be addressed and both releasing of the adhesions and coracoplasty should be considered. Arthroscopic repair is performed with suture anchor reinserting of the tendon at the footprint, with possible medialization of the insertion, with all the variable approaches described for rotator cuff repair; results can be comparable to the ones obtainable with open technique repair, however arthroscopic approach cannot adress the extrarticular retracted lesions.