Deltopectoral approach with partial release of the subscapularis muscle in reverse shoulder arthroplasty

Relevance. This article presents the results of a series of patients who underwent reverse shoulder arthroplasty through a deltopectoral approach without tenotomy or complete cutting of the subscapularis tendon. We believe that the approach we have developed, which allows us to preserve the anatomical attachment of the lower portion of the subscapularis muscle, will reduce the number of complications associated with damage to the area of tendon refixation and reduce the risk of fatty degeneration of the muscle due to early rehabilitation. Aim: improve treatment outcomes in patients after reverse shoulder arthroplasty. Object and methods. In 19 patients, reverse shoulder arthroplasty was performed using a deltopectoral approach with a partial incision of the subscapularis muscle. We cut off 30-50% of the upper part of the tendon, preserving the anatomical attachment of its lower part to the lesser tubercle. Postoperative results were assessed in all patients, X-ray data were studied, range of motion in the joint was measured, subscapularis muscle function was assessed using the lift-off test, joint functionality and pain intensity were analyzed using the ASES and VAS pain scales. Results. Postoperative results were assessed in all patients, X-ray data were studied, range of motion in the joint was measured, subscapularis muscle function was assessed using the lift-off test, joint functionality and pain intensity were analyzed using the ASES and VAS pain scales. Conclusions. deltopectoral approach with partial cutting of the subscapularis tendon provides adequate access to the shoulder joint for installation of a reverse endoprosthesis. Preserving the anatomical attachment of the lower portion of the subscapularis tendon reduces the risk of damage to the refixation zone in the postoperative period and atrophy of the subscapularis muscle.

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