Subscapularis-Sparing Approaches to Total Shoulder Arthroplasty: Ready for Prime Time?

To minimize the risk of subscapularis failure after shoulder replacement, a method of preserving the subscapularis while allowing access to the glenohumeral joint was developed. Only the inferior 30% to 50% of the subscapularis tendon is detached from the humerus, leaving the superior aspect attached to the lesser tuberosity. This subscapularis-sparing, minimally invasive approach to the glenohumeral joint was evaluated in 43 subjects with a minimum 2-year follow-up and subscapularis strength equal to the opposite side. The approach provided adequate exposure for shoulder replacement surgery and decreased risk of postoperative failure of the subscapularis tendon.