Combined Intra-articular and Extra-articular Visualization for Repair of a Complete Subscapularis Tear: The “Blended View” Technique

Abstract

Repair of subscapularis tendon tears can be a challenging task, even for an experienced arthroscopist. The complexity results not only from the difficulty in identifying these tears accurately but also because establishing orientation for visualization and repair of this often distorted anatomy can be difficult. Even after a subscapularis tear is identified and mobilized, restoration of the footprint can prove demanding due to the limited view of the subscapularis tendon’s lesser tuberosity insertion site, especially from the traditional posterior portal. Such visualization limitations often necessitate switching back and forth between 30° and 70° arthroscopes. A “blended view” technique is used routinely because it offers optimal visualization and access to the subscapularis tendon and the lesser tuberosity during full-thickness subscapularis repair.