ArticleInternational orthopaedics2025
Comparison of Anterior Muscle Sparing (AMS) approach and conventional subscapularis tenotomy - repair for deltopectoral approach in reverse shoulder arthroplasty: is there more complications and implant malposition?
Article in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Response to correspondence: Commentary on Muscle-Sparing approaches in reverse shoulder arthroplasty.International orthopaedics · 2026Article
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5 authors.
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Abstract
purposeConserving the subscapularis tendon during reverse shoulder arthroplasty (RSA) has proven its impact on postoperative outcomes, particularly regarding stability and range of motion. A subscapularis preserving approach has been developed: the Anterior Muscle Sparing (AMS) approach that enables not to violate the subscapularis tendon. Our aim was to compare this approach with the conventional approach, which consists of reinserting the subscapularis at the end of the procedure, with a specific focus on intraoperative complications and postoperative position of the implants.
methodsA retrospective consecutive study was performed of patients undergoing a primary RSA between January 2021 and December 2024 performed by the same surgeon. We included 32 patients receiving the standard approach (SA) and 24 patients receiving the AMS approach. Implant positioning was assessed through three different variables: the glenoid implant inclination relative to the floor of the supraspinatus fossa; the glenoid implant height described as the distance between the inferior border of the glenoid bone surface and the inferior part of the glenoid baseplate; and the humeral stem alignment relative to the intramedullary humeral shaft axis.
resultsThere were no significant differences in terms of glenoid implant inclination (-4.71 ± 6.3° Vs -3.8 ± 7.17°; p = 0.68), glenoid implant height (0.608 ± 1.94 mm Vs 0.315 ± 0.896 mm ; p = 0.655), and PERFORM
conclusionWhen compared to the standard approach, the AMS showed no significant difference in terms of implant positioning, surgical operative times and intraoperative complication rate. An attempt to preserve the subscapularis tendon seems to be always justified, as this method is a safe and reliable alternative to the traditional approach. LEVEL OF EVIDENCE: Level III, Retrospective Cohort Comparison Treatment study.
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