Subscapularis Insufficiency: What’s All the Fuss About?

Abstract

There has been increase attention to the surgical treatment of the subscapularis (SSC) tendon with risk of postoperative dysfunction and early failures following shoulder arthroplasty. Studies investigating the clinical results after shoulder arthroplasty indicate that SSC tendon detachment or incision techniques and rehabilitation concepts may impair SSC recovery and consequently the postoperative function. In response to these results, technical modifications have been proposed and evaluated anatomically, biomechanically, and clinically. The aim of this article is to give an overview of current SSC take-down approaches, subsequent repair techniques, and postoperative rehabilitation protocols as well as to present the diagnostic algorithm and clinical impacts of the increasingly acknowledged condition of SSC insufficiency following shoulder arthroplasty procedures.