Retrospective cohort study comparing subscapularis peel (tenotomy) vs. lesser tuberosity osteotomy (LTO) in 60 TSA shoulders, using ultrasound, physical examination, and validated outcome measures (WOOS, DASH, Constant Score) to determine which technique better preserves subscapularis integrity and function at minimum 1-year follow-up.
When evaluating a TSA patient with unexpectedly high external rotation or suboptimal WOOS/DASH scores, obtain subscapularis ultrasound — clinical tests alone (belly press, bear hug) are unreliable for detecting attenuation or partial rupture, and ultrasound-detected abnormalities carry meaningful functional consequences regardless of which takedown technique was used.
Retrospective cohort study comparing subscapularis peel (tenotomy) vs. lesser tuberosity osteotomy (LTO) in 60 TSA shoulders, using ultrasound, physical examination, and validated outcome measures (WOOS, DASH, Constant Score) to determine which technique better preserves subscapularis integrity and function at minimum 1-year follow-up.
When evaluating a TSA patient with unexpectedly high external rotation or suboptimal WOOS/DASH scores, obtain subscapularis ultrasound — clinical tests alone (belly press, bear hug) are unreliable for detecting attenuation or partial rupture, and ultrasound-detected abnormalities carry meaningful functional consequences regardless of which takedown technique was used.