Shoulder Arthritis: Maintaining Shoulder Stability Following Shoulder Replacement Surgery With Tendon Repair Animation

Shoulder Arthritis: Maintaining Shoulder Stability Following Shoulder Replacement Surgery With Tendon Repair Animation

To access the shoulder joint during shoulder replacement surgery, the subscapularis, 1 of the rotator cuff muscles located at the front of the shoulder, needs to be separated from the upper arm bone. After the shoulder replacement is complete, the subscapularis then needs to be reattached to the upper arm bone to hold the shoulder in place.

This animation demonstrates a repair of the subscapularis tendon following a shoulder replacement for the treatment of shoulder arthritis. Here, we see a right upper arm bone, or humerus, with the front of the arm facing the screen. The subscapularis tendon has already been detached from the upper arm bone, and most of the total shoulder replacement is already complete.

The plastic socket implant has been placed in the shoulder socket, and the metal implant, which will be attached to a metal ball, has been placed in the top of the upper arm bone. A guide is placed on top of the metal implant in the upper arm bone, which is used to safely position anchors so that they do not interfere with the implant.

First, 3 soft body anchors are inserted into the upper arm bone. These anchors are already threaded with 2 strands of sutures. Two holes are then drilled into the upper arm bone where the subscapularis was attached. The metal ball is attached to the metal implant to complete the shoulder replacement, and the upper arm bone is relocated back into the shoulder socket.

Next, the subscapularis will be repaired. The suture strands from each anchor are passed through the subscapularis tendon. Then, 1 strand from each of the 3 anchors is threaded through a hard body anchor, which is inserted into 1 of the holes made in the upper arm bone. The same steps are repeated for the other suture strands with another anchor.

These anchors tack down the subscapularis back to the upper arm bone to help hold the bone in the shoulder socket. This completes the subscapularis tendon repair and shoulder replacement surgery.