Subscapularis Tenotomy: Optimal Approach to Shoulder Replacement: Opposes

摘要

Management of the subscapularis muscle-tendon complex is of paramount importance in shoulder arthroplasty done via the deltopectoral approach. Detachment of the subscapularis is a prerequisite for shoulder dislocation and placement of the prosthetic components, and subsequent repair can have a strong influence on functional outcomes. Anatomic integrity of the subscapularis repair has implications for glenohumeral stability, range of motion, and strength, and the degree and rate of healing affect postoperative rehabilitation. The various methods of subscapularis detachment include tenotomy, subperiosteal elevation, and osteotomy of the lesser tuberosity. We review recent literature and offer our own experience in support of lesser tuberosity osteotomy as the optimal technique for subscapularis detachment in shoulder arthroplasty via the deltopectoral approach.