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Related Concept Videos

Muscles that Move the Arm01:31

Muscles that Move the Arm

Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...
Muscles of the Shoulder01:23

Muscles of the Shoulder

The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
Anterior Thoracic Muscles
The anterior thoracic muscles include the serratus anterior, subclavius, and...
Bones of the Upper Limb: Humerus01:19

Bones of the Upper Limb: Humerus

The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...

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Related Experiment Video

Updated: Jul 10, 2026

Reverse Total Shoulder Arthroplasty
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Subscapularis function after total shoulder replacement: results with lesser tuberosity osteotomy.

Sheeraz Qureshi1, Andrew Hsiao, Raymond A Klug

  • 1Department of Orthopaedics, Mount Sinai Medical Center, New York, NY, USA.

Journal of Shoulder and Elbow Surgery
|November 21, 2007
PubMed
Summary

Lesser tuberosity osteotomy reliably restores subscapularis function and internal rotation strength after total shoulder arthroplasty. This technique shows improved outcomes compared to traditional soft tissue repair methods.

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Area of Science:

  • Orthopedic Surgery
  • Shoulder Arthroplasty
  • Musculoskeletal Research

Background:

  • Subscapularis tendon integrity is crucial for shoulder function after total shoulder arthroplasty.
  • Anatomic soft tissue repair of the subscapularis has shown variable outcomes, with some patients experiencing loss of internal rotation strength.
  • Previous methods, including soft tissue repair with or without bone tunnels, did not consistently restore subscapularis function.

Purpose of the Study:

  • To evaluate the efficacy of lesser tuberosity osteotomy for subscapularis repair in total shoulder arthroplasty.
  • To assess the restoration of internal rotation strength and subscapularis function using this technique.
  • To compare the outcomes of lesser tuberosity osteotomy with prior soft tissue repair methods.

Main Methods:

  • Retrospective review of 28 patients (30 shoulders) who underwent total shoulder arthroplasty between 2001 and 2003.
  • Subscapularis muscle was removed with a small bone piece via lesser tuberosity osteotomy and repaired using bone tunnels.
  • Follow-up averaged 1.1 years, with evaluation of terminal internal rotation via belly-press examination and subscapularis function by assessing the ability to tuck in a shirt.

Main Results:

  • 83.3% of patients (25/30) reported no difficulty tucking in their shirt, indicating good subscapularis function.
  • 60% of patients (18/30) had normal belly-press examination results, demonstrating restored internal rotation strength.
  • Patients undergoing lesser tuberosity osteotomy showed improved results compared to a previous cohort with soft tissue repair.

Conclusions:

  • Lesser tuberosity osteotomy provides reliable restoration of internal rotation strength and subscapularis function after total shoulder arthroplasty.
  • This osteotomy technique facilitates bony healing at the repair site, leading to enhanced functional recovery.
  • The study suggests that lesser tuberosity osteotomy is a superior method for subscapularis repair in total shoulder arthroplasty compared to traditional soft tissue repairs.