Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 27, Issue 12, pp 3997–4004 | Cite as

Arthroscopic subscapularis augmentation combined with capsulolabral reconstruction is safe and reliable

  • Shiyou Ren
  • Xintao Zhang
  • Ri Zhou
  • Tian You
  • Xiaocheng Jiang
  • Wentao ZhangEmail author



The study aimed to compare modified arthroscopic subscapularis augmentation (MASA) with tenodesis of the upper third of the subscapularis tendon using a tendon combined with capsulolabral reconstruction (Group A) or Bankart repair (Group B) for recurrent anterior shoulder instability (RASI).


A retrospective series of 49 patients underwent primary surgery for RASI with glenoid bone loss (GBL) < 25%. Outcomes included the Oxford Shoulder Instability Score (OSIS), Visual Analogue Scale (VAS) score, Rowe score, and American Shoulder and Elbow Surgeons (ASES) functional outcome scale score. Recurrent instability, sports activity level, and range of motion (ROM) were also analysed.


No significant differences were observed at baseline. Forty-six patients were available for more than 2 years of follow-up. At the last follow-up after surgery, the patients in both groups had experienced significant improvements in all outcome scores (P < 0.05 for all), and obvious decreases in forward flexion and external rotation were noted in both groups (P < 0.05 for all). Group A had superior ASES scores, VAS scores, and OSISs (P < 0.05) but did not experience significant differences in either the Rowe score or ROM compared to Group B. Group A had lower rates of recurrent instability and superior outcomes for the return to sports activities. One patient in Group A had subluxation, and 4 patients in Group B had dislocation or subluxation. No patients in either group experienced neurovascular injury, joint stiffness, or surgical wound infection.


For RASI with GBL < 25%, MASA with tenodesis of the upper third of the subscapularis tendon using a tendon combined with capsulolabral reconstruction was a safe technique that produced better outcomes in terms of ASES scores, VAS scores, OSISs, the return to sports, and postoperative recurrent instability and did not decrease the ROM compared to that achieved by arthroscopic Bankart repair.

Level of evidence



Recurrent shoulder instability Anterior instability Capsulolabral reconstruction Subscapularis augmentation 



This study was supported by Sanming Project of Medicine in Shenzhen (Grant No. SZSM201612078).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

IRB approval was obtained (Peking University Shenzhen Hospital, approval, ID: 201768).


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  • Shiyou Ren
    • 1
  • Xintao Zhang
    • 1
  • Ri Zhou
    • 1
  • Tian You
    • 1
  • Xiaocheng Jiang
    • 1
  • Wentao Zhang
    • 1
    Email author
  1. 1.Department of Sports Medicine and RehabilitationPeking University Shenzhen HospitalShenzhenChina

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