Subscapularis lengthening in shoulder arthroplasty

PurposeTo report the technique and outcome of subscapularis (SSC) lengthening in shoulder arthroplasty.ProcedureWhen external rotation measures less than 20°, a coronal subscapularis lengthening is performed. This utilizes the interval between the anterior shoulder capsule and subscapularis to titrate the correct amount of anatomic length.ResultsAverage preoperative passive ER was -2°. Average postoperative ER was 48°. Belly press was graded as normal in 13 pts, mild in 12 pts, and poor in 2 pts.ConclusionSubscapularis tendon lengthening provides a large surface area for tendon healing and allows anatomic length to be restored. Subscapularis lengthening may preserve a better length-tension relationship of the SSC muscle in shoulders with significant IR contracture undergoing shoulder arthroplasty.