J Am Acad Orthop Surg. 2014 Feb;22(2):80-9. doi: 10.5435/JAAOS-22-02-80.
As the largest and most powerful rotator cuff muscle, the subscapularis plays a critical role in proper shoulder function. The diagnosis of subscapularis tears is made based on history and physical examination and confirmed with imaging studies. Historically, subscapularis tears have been addressed in an open fashion. Recent literature has demonstrated successful all-arthroscopic repair of isolated subscapularis tears and anterosuperior rotator cuff tears. Successful arthroscopic treatment follows several critical steps: patient positioning, portal placement, obtaining adequate visualization and working space, identifying and mobilizing the subscapularis tendon, preparation of the tendon edge and lesser tuberosity, appropriate anchor placement, suture passage, and finally, secure knot-tying and fixation. Excellent functional and clinical outcomes following these steps have been demonstrated by various investigators. Additional research is needed, however, because direct comparison between all-arthroscopic and open subscapularis repair is limited, and neither technique has proved to be superior.
作为最大和最强的肩袖肌肉，肩胛下肌在肩部功能中起着至关重要的作用。肩胛下肌撕裂的诊断基于病史和体格检查，并通过影像学研究证实。历史上，肩胛下肌撕裂是通过开放性手术来处理的。最近的文献表明，孤立的肩胛下肌撕裂和前上肩袖撕裂可以通过全关节镜修复成功。关节镜治疗的成功需要遵循几个关键步骤：患者体位、入路选择、获得足够的可视化和操作空间、识别和移动肩胛下肌腱、准备肌腱边缘和小结节、适当的锚钉放置、缝线通过，最后，牢固的打结和固定。各种研究人员已经证明，这些步骤之后可以获得出色的功能和临床结果。然而，还需要进一步的研究，因为全关节镜和开放性肩胛下肌修复之间的直接比较有限，而且两种技术都没有被证明是优越的。
