2021 Annual Meeting Shoulder Access Pass-Surgical Technique Spotlight: Subscapularis Repair (cadaveric demo)

Surgical Technique Spotlight: Subscapularis Repair (cadaveric demo)

Video Transcription

Video Summary

This video details the arthroscopic technique for double row subscapularis tendon repair, performed in the beach chair position on a left shoulder. The presenters emphasize understanding subscapularis anatomy—its broad footprint and relationship with the supraspinatus—and advocate preoperative MRI review to identify tears and biceps instability. The procedure involves creating portals, releasing the capsule for mobility, cleaning the lesser tuberosity footprint, and placing anchors about 2 cm apart for suture passage through the tendon. The biceps tendon, often unstable or torn, is managed appropriately, sometimes incorporated in the repair or addressed with biceps tenodesis if pathologic. The technique includes tensioning sutures carefully, achieving an anatomic repair with a strong suture bridge. They note challenges such as tissue mobility and biceps interference, stressing good visualization and flexibility between single versus double row repairs. Clinical outcomes are positive, especially in younger patients with isolated tears, but the team advises conversion to open surgery if arthroscopic repair is difficult.

Asset Caption

Dr. Anthony Romeo

Keywords

arthroscopic subscapularis repair

double row technique

beach chair position

biceps tenodesis

lesser tuberosity anchors

subscapularis anatomy