Management of Subscapularis Tendon Tears

Subscapularis tendon pathologies present challenges to the shoulder surgeon at every stage of management: in understanding normal and pathoanatomy, in establishing the correct diagnosis, in making treatment decisions, and in executing an arthroscopic surgical repair. In this article, we summarize the principles and key points of knowledge for successful management of tears of the subscapularis tendon and associated structures. Anatomical and biomechanical studies continue to broaden our understanding of the critical role of the upper subscapularis tendon, where tears are most common yet difficult to screen for with preoperative imaging studies and physical examination. Arthroscopic techniques have become invaluable tools for the surgeon in diagnosis and repair of subscapularis tendon and associated tears, and these are discussed in detail. With proper surgical technique and postoperative management, isolated or combined repair of the subscapularis tendon routinely results in improved patient outcomes, with low reported complication rates.