Managing the tight shoulder: Subscapularis lengthening - In opposition

Subscapularis contracture is a significant challenge facing the shoulder arthroplasty surgeon. Debate continues as to the best technique to restore external rotation in the setting of the osteoarthritic shoulder undergoing arthroplasty. The authors' rationale for subscapularis release as favored over lengthening is presented. A discussion of the technique for anatomic reattachment of the tendon with a lesser tuberosity osteotomy is included as well.