A New Method for Knotless Fixation of an Upper Subscapularis Tear

The advancement of shoulder arthroscopy has provided the opportunity to see the articular side of the rotator cuff and has led to increased recognition of subscapularis tears. One of the unique challenges to arthroscopic subscapularis repair is the small anterior space overlying the subscapularis. Whereas the subacromial space allows freedom of movement, the limited subcoracoid space makes visualization, instrument manipulation, and knot tying more difficult. We describe a technique for knotless restoration of the upper subscapularis footprint that eases some of the aforementioned difficulties. The technique is indicated for partial- or full-thickness tears of the upper 50% of the subscapularis tendon and therefore applies to the majority of tears involving the subscapularis tendon.