ABSTRACT
Subscapularis function and the clinical relevance of subscapularis pathology have recently received significant attention. A heightened awareness of subscapularis injury, refined clinical exam tests, and increasing familiarity with arthroscopic inspection of the subscapularis tendon have led to more frequent diagnosis of subscapularis tendon tears (1-4). Advanced arthroscopic techniques now allow accurate identification of subscapularis pathology and reliable treatment (1,2,4-8). The subscapularis, however, remains the most difficult of the rotator cuff tendons to repair arthroscopically for several reasons. The subcoracoid space is significantly constrained making visualization and manipulation of instruments here challenging. The completely torn subscapularis tends to retract and scar far medially in a position where visualization and manipulation of the tendon is even further compromised. Finally, the subscapularis tends to scar to the coracoid in close proximity to important neurovascular structures making mobilization a particularly daunting task. It is clear that subscapularis tendon tears can occur in isolation or as part of the continuum of large and massive anterosuperior rotator cuff tears (1,2,9-11).
