Subscapularis Preserving Technique in Anatomic Total Shoulder Arthroplasty. The Superior and Inferior Approach.

Subscapularis tenotomy for anatomic total shoulder arthroplasty has been the standard approach for shoulder surgeons that use the deltopectoral approach. The risk of subscapularis insufficiency after this approach has been well documented. In order to avoid subscapularis complications, subscapularis sparing approaches through the rotator interval have been developed. We present two alternative subscapularis preserving techniques that are performed through the deltopectoral interval and allow more complete osteophyte excision and accurate humeral head sizing. These techniques require modified instrumentation and are facilitated by the use of an adaptable prosthesis with dual eccentricity. Future studies will examine the comparative clinical and radiographic outcomes of these techniques.