Arthroscopic Management of Subscapularis Tears

Tears of the subscapularis were previously believed to be rare, but are now recognized to be very common. As maintenance of the subscapularis footprint is integral to normal biomechanical function of the shoulder it is important for the shoulder surgeon to be adept at recognizing and treating these tears. A combination of physical examination tests can be used to determine both the presence and size of a subscapularis tear. Compared with posterosuperior rotator cuff tears, magnetic resonance imaging detection of subscapularis is less reliable and therefore requires a high index of suspicion. Arthroscopic repair of the subscapularis presents unique challenges but can be safely and successfully performed with careful attention to detail. The results of arthroscopic subscapularis repair are encouraging at intermediate follow-up and comparable with or better than that reported with open repair.