Yeah, we looked at some stuff already, but if you see the biceps is subluxed, you know the subscap is gonna have some pathology, so anticipate it that way. Also, you wanna look, in this case, you can see the subluxed biceps, but look for bony deformities, just as you mentioned. If you wanna place an anchor in a particular location, you gotta know what the bone looks like, and so look for these cysts, which you can see, and here's the subluxed biceps. I like to use a traction stitch. Can you go back one, please? You can. I can. You just go back. All right, there you go. I like to use a traction stitch. There's a right shoulder viewing from posterior, and a number one PDS, and I'll bring it through a stab incision laterally, and this helps me gain control of the tendon. I typically use it for the full thickness tears, and then you can bring it over and help with your releases, and that's where it looks like through the skin. Visualization is important. Merrick, you brought that up earlier. If you flex the arm, you can see the less tuberosity better, and then viewing from lateral down the subscap as you do your releases is helpful. Suture passage, to me, this is the tendon of ulcers on this angle, and here's one with a bony ossicle there, so I like to pass my sutures along that angle, and I think it has a good bite that way, and then maintain the comma tissue. Here's a left shoulder viewing from lateral, the traction suture's in place. You've got good mobility. The other thing it does is it brings the posterior superior cuff laterally, and the essential feature for that is the comma tissue, so I tend to maintain that. I don't release it, although there has been some publications along those lines, and I thought I would, since you're polling the panel, I thought I'd ask one question. It's predominantly for all of you, a show of hands, for subscapularis, full thickness subscapularis tears, one answer, predominantly, single row or double row? Let's start with single row. All right, so we don't even have to ask double row. All right, suture spaghetti. But a quick comment about John's subscapularis tears. You can sit there. I'm not gonna ask questions. No, but because of John, and this stuff over the past 10 years, I know I do so many more subscapularis repairs, and patients do so much better, and even when it's a small tear, if you address that, they will be much more stable, and they'll recover, and I think a lot of our rotator cuff failures in the past where we thought we did a good repair of the supraspinatus is that we missed that subscapularis, so kudos to the guys who brought this one. Yeah, I would echo that. You know, I think your subscap is the key to success, and even these small subscap tears, take the time and repair it. This is a place where you can pass a single tape and go to a knotless anchor if you're not really comfortable in the front of the shoulder. That may be easier for you, too. So one of the.

shoulder injuries

biceps

subscapularis

traction stitch

subscapularis tears