An Improved Continuous Suturing Technique Using a Suture Hook for Subscapularis Repair

Subscapularis tendon injuries often pose substantial challenges in arthroscopic repair, with traditional techniques frequently limited by prolonged surgical time, uneven tension distribution, and increased complication risk. Although advanced suture-passing and suturing methods can improve biomechanical outcomes, they generally require complex instrumentation. A hybrid approach is presented here that integrates a continuous sewing machine-like suture technique with a single-portal spinal needle method for subscapularis repair. The sewing machine-like technique facilitates efficient loop formation, which ensures even tension distribution and allows precise suture placement through flexible puncture points. The single-portal approach minimizes invasiveness, reduces tissue trauma, and streamlines the surgical process. Collectively, these techniques enhance the biomechanical strength, shorten operative time, and align with the principles of modern minimally invasive surgery. This improved and innovative strategy represents a promising alternative to conventional methods, with the potential to improve clinical outcomes. Further clinical validation and long-term follow-up are required to confirm its efficacy.