Technical Problems Encountered with Subscapularis and the Superior Cuff in Shoulder Arthroplasty

Using the delto-pectoral approach to insert a shoulder arthroplasty allows any of the inherent problems of the rotator cuff to be dealt with: retraction or rupture. Subscapularis lengthening, using whichever technique (release through glenoid capsulotomy, coronal ‘Zplasty’ of the tendon, medial reattachment of the tendon), is an essential step in the operation, but the axillary nerve must be identified before it is carried out.