This post was written by Dr. Michael Rosen, DO, Orthopedic Surgery.
If you’ve been told you may need a shoulder replacement, you’re not alone. Every year, hundreds of thousands of people find relief from painful shoulder conditions through total shoulder arthroplasty (TSA), a surgery that replaces the damaged joint with smooth, artificial surfaces.
The benefits of advanced techniques
Today, shoulder replacement surgery has evolved to become safer, more precise and less disruptive to your natural anatomy. One of the most exciting advancements is the subscapularis-sparing approach, a technique designed to protect an important shoulder muscle and help you recover faster.
In traditional shoulder replacement surgery, the surgeon needs to detach or split this muscle to access the joint. Repair of this muscle following the procedure is crucial to recovery and requires a course of immobilization after surgery to protect this repair. While this approach has worked well for many years, it can sometimes lead to weakness, stiffness or slower recovery while the muscle heals.
With the subscapularis-sparing technique, the surgeon can perform the entire shoulder replacement without cutting the subscapularis tendon. Instead, they access the joint through a natural interval between muscles.
This innovative method allows the surgeon to replace the damaged joint surfaces while preserving the integrity of the subscapularis, meaning less disruption to your shoulder’s natural function.
Understanding the pros of TSA
Patients who undergo subscapularis-sparing TSA often experience several key advantages:
- Faster initial recovery: Because the subscapularis is not detached, you may regain motion and strength sooner.
- Improved shoulder function: Protecting this important muscle helps maintain natural strength and stability.
- Reduced post-operative pain: Less muscle trauma can mean less discomfort in the early recovery period.
- Lower risk of tendon problems: There’s less risk of subscapularis failure or weakness over time.
Not everyone is a candidate for a subscapularis-sparing shoulder replacement. The technique is most effective for patients with primary osteoarthritis and without significant deformities to shoulder anatomy.
Your orthopedic surgeon will review your imaging, shoulder strength and medical history to determine if this approach is right for you.
What to expect after surgery
Recovery still involves a period of rest, physical therapy and gradual return to daily activities. But many patients report a smoother early recovery compared to traditional techniques. The course of immobilization that was previously necessary to protect the subscapularis repair is no longer required, allowing for much faster return to function.
You’ll work closely with your physical therapist to restore range of motion and build strength safely. Most patients begin gentle use of the arm within a few weeks and notice meaningful improvement in pain and function as healing continues.
A step forward in shoulder care
Subscapularis-sparing TSA represents a major step forward in joint replacement surgery, one that prioritizes both precision and preservation. By protecting the muscles that make your shoulder strong, this approach helps you get back to the activities you love with confidence and comfort.
If you’re considering shoulder replacement surgery, talk with your orthopedic specialist about whether a subscapularis-sparing approach might be right for you. Every shoulder is unique, and the best treatment is the one tailored to your needs, goals and lifestyle.
