Intra-articular Subscapularis Repair Using Transtendon Lasso-Loop Technique With All-Suture Anchor

The subscapularis tendon is vital for glenohumeral stability by balancing force couples and preventing superior humeral migration. Untreated tears can disrupt force coupling, accelerate degeneration, and affect functional outcomes, especially with concomitant supraspinatus or infraspinatus injuries. Traditional open and arthroscopic repair methods for subscapularis tears encounter technical difficulties, such as limited visualization, tendon retraction, and fixation challenges. Although the lasso-loop suture technique has improved tissue grip, conventional metal or PEEK (polyether ether ketone) anchors may have drawbacks such as bone stock compromise or inflammatory reactions. To address these limitations, we describe a transtendon lasso-loop technique using all-suture anchors for intra-articular subscapularis repair, without the use of a suture hook or suture passer. This technique combines the biomechanical benefits of the lasso-loop configuration and the bone-preserving features of all-suture anchors to optimize footprint restoration and reduce iatrogenic damage. The transtendon design also enables anatomic reattachment of partial articular tears while maintaining the integrity of the native tendon.