Simplified Technique for Arthroscopic Repair of Upper Third Subscapularis Tear by Percutaneous Spinal Needle Suture Passing with a T Shape Loop

The subscapularis tear is a commonly seen shoulder injury requiring arthroscopic repair. This article describes a simplified arthroscopic technique for repairing the upper third subscapularis injury. The procedure includes the steps of subscapularis tear identification, decortication of the footprint and freshening, percutaneous suture passage using a spinal needle, construction of a T-shaped suture loop, and placement of a single lateral row anchor. This technique replaces traditional suture-passing devices and traction sutures with a 12G spinal needle loaded with a high-tensile suture. Its novelty lies in the combination of a percutaneous spinal needle for suture passage and the construction of a T-shaped suture loop. The final construct, securing the tendon with the T-loop and a single lateral row anchor, provides robust compression at the insertion site. Our simplified technique offers distinct advantages of easier suturing passing operation, more convenient suture management, more flexible insertion site selection, less invasive to patients, and higher error tolerance for iatrogenic damage, and it should be a promising technique in clinical situations.