Subscapularis Tendon Tear Repair

by Dr. Richard Bartholomew

The subscapularis tendon is the largest and strongest muscle of the rotator cuff and plays a major role in shoulder function. Subscapularis lesions are often partial tears that are easily missed, unlike complete tears, which are usually obvious. With the advancement of arthroscopic techniques and instrumentation, subscapularis tendon tears are readily identified and repaired. When a partial subscapularis tear is incidentally visualized during other arthroscopic procedures, the subscapularis must be corrected to restore its tenodesis effect to balance the force couple at the glenohumeral joint and prevent tear propagation.

Subscapularis Tear | Subscapularis Repair

Often the subscapularis tendon was only treated when it was a complete tear by traditional open methods. Fortunately, new instrumentation and techniques have been devised to address the subscapularis tear arthroscopically at the same time of the other pathology treatment. An understanding of coracoid morphology leads us to believe that a prominent or hooked coracoid causes subscapularis tearing (similar to the acromion process with supra/infraspinatous tears). Therefore a coracoplasty is performed as well.  Injury to the biceps tendon in conjunction with the subscapularis tendon is common because of its proximity to the subscapularis tendon. The medial sling of the biceps (as it lies in the intertubercular groove) is composed of the coracohumeral ligament and superior glenohumeral ligament often tearing in conjunction with the subscapularis. Thus, a tenodesis or tenotomy is usually performed at the same time.

Schedule a Subscapularis Tendon Tear Repair consultation with our shoulder expert, Dr. Bartholomew.

Call Bone and Joint Specialists at (248) 673-0500.