title: Subscapularis function after primary tendon to tendon repair in patients after replacement arthroplasty of the shoulder.
abstract: OBJECTIVE
  We studied the results of tendon-to-tendon repair of the subscapularis during total shoulder arthroplasty (TSA) to compare its clinical results relative to more recent studies looking at osteotomy of the lesser tuberosity.
  
  
  METHODS
  This study analyzed the postoperative integrity of the subscapularis by a tendon-to-tendon repair in 45 arthroplasties in 43 patients.
  
  
  RESULTS
  Preoperatively, 23 patients had a negative lift-off test; 22 could not perform the test. Postoperatively, 41 patients had a negative lift-off test; four could not reach behind themselves to do the test. All 45 shoulders had a negative belly-press test pre-operatively and post-operatively.
  
  
  CONCLUSIONS
  Tendon-to-tendon repair is simpler, quicker, and avoids the possibility of an osteotomy nonunion. Tendon-to-tendon repair of the subscapularis tenotomy in shoulder arthroplasty remains an option in the presence of reasonable quality tendon, utilizing relaxing sutures (partial closure of the lateral rotator interval), and limiting early postoperative passive external rotation.
  
  
  METHODS
  Level 4; Retrospective case series, no control group.
authors.affiliation: The Department of Orthopedic Surgery, The George Washington University, Washington, DC 20037, USA.
authors.forename: Jill L
authors.initials: JL
authors.lastname: Caplan
authors.forename: Bryan
authors.initials: B
authors.lastname: Whitfield
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Neviaser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D012785:Shoulder Joint / Q000601:surgery*; D013710:Tendons / Q000502:physiology* / Q000601:surgery*