Arthroscopic Augmentation With Subscapularis Tendon in Anterior Shoulder Instability With Capsulolabral Deficiency Marco Maiotti, M.D., Carlo Massoni,

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Arthroscopic Augmentation With Subscapularis Tendon in Anterior Shoulder Instability With Capsulolabral Deficiency Marco Maiotti, M.D., Carlo Massoni, M.D. Arthroscopy Techniques Volume 2, Issue 3, Pages e303-e310 (August 2013) DOI: 10.1016/j.eats.2013.04.005 Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 1 Subscapularis tendon elongation in chronic anterior shoulder instability. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 2 Subscapularis tendon elongation is not corrected by capsulolabral repair. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 3 A 3.5-mm nonabsorbable knotless PEEK suture anchor loaded with multi-strand tape. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 4 Capsulolabral complex augmentation in the absence of the ligament-labrum complex or with deficiency of the ligament-labrum complex using the articular portion of the subscapularis tendon. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 5 Large anterior pouch with poor capsulolabral tissue quality and absence of the labrum. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 6 Bone hole drilling at the 9-o'clock position for subscapularis tendon fixation (left shoulder). Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 7 Anteroinferior capsulorrhaphy (left shoulder). Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 8 A suture-passing device loaded with multi-strand tape is used to perforate the articular portion of the subscapularis tendon from the lower cannula. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 9 (A) One of the free ends of the tape is carried out from the upper cannula with a suture retriever. (B) External point of view of procedure. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 10 The anchor bone hole direction and depth are assessed with a punch device. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 11 (A) A suture anchor is pushed along the tape through the lower cannula (external point of view). (B) Insertion of suture anchor's eyelet into bone hole. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 12 Advancement of the subscapularis tendon to the glenoid neck with restoration of the anterior wall. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

Fig 13 Anterosuperior view: complete closure of anterior pouch and centering of humeral head in glenoid cavity. Arthroscopy Techniques 2013 2, e303-e310DOI: (10.1016/j.eats.2013.04.005) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions