Arthroscopic repair of subscapularis tear

Arthroscopic repair
Skillful neglect
Repair indication
Arthroscopic repair steps

Portals for SSc repair

Release and mobilization
Repair technique
For successful arthroscopic repair

 repair?

superior lateral edge of the SSC: initial tear site that propagates inferiorly


Repair these partial SSc tear for anatomic, structural, and functional restoration of the shoulder.


For securely repair of SSt

Skillful neglect?

No difference between repair and shaving

→ IR power, Constant score, DASH (20 Pt, 2.5yr f/u)

Repair indication : Controversal

Arthroscopic repair steps

Visualization : Torn tendon & exposed footprint

Portal formation: manipulation

Traction suture

Release and Mobilization: 3-sides

Repair technique: single vs double row ?


Portals for SSC repair

Post. portal : viewing

Ant. portal  : anchor placement and suture passage

Anterolateral portal : SSC mobilization and preparing of bone bed

Accessory anterolateral portal : for traction sutures if necessary



Release and Mobilization

Medialize the footprint if needed



Repair technique

Single-row vs Double-row

: satisfactory clinical outcomes and structural integrity with no significant differences







Isolated SSc full thickness tear : double row > single row??

not always conferring superior clinical outcomes



Is open repair better?

       Bartl, Arch Orthop Trauma Surg 2012

          :  4% re-tear subscap, 19% supraspinatus

Chronic, retracted, atrophied  open may be best option ??

    Edwards et al JBJS 2005  89% excellent / good





For Successful A/S Repair 

Anatomy is power !!

1) identify the torn tendon and footprint

2) work under the ‘Comma’ to expose

3) mobilization, adhesiolysis

4) then do repair


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