Subscapularis lengthening in shoulder arthroplasty

Purpose: To report the technique and outcome of subscapularis (SSC) lengthening in shoulder arthroplasty. Procedure: When external rotation measures less than 20 degrees, 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. Results: Average preoperative passive ER was -2 degrees. Average postoperative ER was 48 degrees. Belly press was graded as normal in 13 pts, mild in 12 pts, and poor in 2 pts. Conclusion: Subscapularis 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. Level of evidence: III; Case-control study; Treatment study (C) 2010 Journal of Shoulder and Elbow Surgery Board of Trustees.