Lesser Tuberosity Osteotomy: The Door to Shoulder Replacement

As total shoulder replacement has evolved, the subtle nuances of soft tissue balancing and subscapularis function have emerged as key issues for improving patient outcomes. Subscapularis dysfunction is an under-recognized problem within the orthopedic community. Causes of dysfunction are rupture of the subscapularis tendon, nerve injury, or nonanatomic restoration of the muscle tendon unit moment arm. Lesser tuberosity osteotomy provides excellent surgical exposure, optimizes healing potential, and improves postoperative subscapularis function.