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Updated: Jun 25, 2026

Reverse Total Shoulder Arthroplasty

Reverse Total Shoulder Arthroplasty

Published on: July 5, 2011

Subscapularis Management With Biologic Augmentation in Anatomic Total Shoulder Arthroplasty.

Gloria Coden¹, Jason Corban¹, Lampros Minos¹

¹New England Baptist Hospital, Boston, Massachusetts, U.S.A.

Arthroscopy Techniques

|June 5, 2024

Summary

This study introduces a novel technique for subscapularis repair after total shoulder arthroplasty (TSA) using a peel-tenotomy and bone marrow aspirate concentrate (BMAC). The method aims to enhance subscapularis repair robustness and reduce post-operative insufficiency.

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Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears

Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears

Published on: May 9, 2025

Area of Science:

Orthopedic Surgery
Biologics in Musculoskeletal Repair

Background:

Subscapularis insufficiency is a significant complication following anatomic total shoulder arthroplasty (TSA).
Biologic augmentation strategies have shown promise in enhancing rotator cuff repair outcomes.

Purpose of the Study:

To describe a surgical technique for subscapularis repair after TSA.
To investigate the use of a peel-tenotomy and bone marrow aspirate concentrate (BMAC) for subscapularis augmentation.

Main Methods:

A standard deltopectoral approach was utilized.
A peel-tenotomy involved detaching most of the subscapularis tendon from the lesser tuberosity.
Bone marrow was aspirated from the humeral head, processed, and applied to the repair site before and after suture fixation using a double-row technique.

Main Results:

The described technique facilitates a secure double-row subscapularis repair.
Bone marrow aspirate concentrate (BMAC) is applied to augment the tendon repair.

Conclusions:

The described technique offers a method for robust subscapularis repair after TSA.
This approach may potentially decrease subscapularis insufficiency rates following TSA, though further research is warranted.