# The Open-Book Technique With Sliced Biceps Tendon Autograft Augmentation in the Reconstruction of the Subscapularis in Shoulder Arthroplasty

## TL;DR

This paper introduces a new surgical technique using sliced biceps tendon to improve subscapularis reconstruction during shoulder arthroplasty.

## Contribution

The novel technique uses sliced biceps tendon autograft for subscapularis augmentation after tenotomy in shoulder arthroplasty.

## Key findings

- The sliced biceps tendon autograft offers a replicable and cost-effective solution for subscapularis augmentation.
- This technique addresses poor tendon tissue quality and prior surgical challenges in shoulder arthroplasty.

## Abstract

Postoperative insufficiency of the subscapularis can diminish clinical outcome after shoulder arthroplasty. Poor tendon tissue quality and prior surgery can impair the possibility of reconstruction and healing, as well as the postoperative range of motion and strength. Patch augmentation has been investigated for soft tissue augmentation in the glenohumeral joint utilizing different graft materials. Recently, the surgical technique using compressed biceps tendon autograft was introduced for the subscapularis augmentation following shoulder arthroplasty. However, the viable cell potential after mechanical compression remains uncertain. Therefore, we propose an augmentation technique of the subscapularis tendon using a sliced autograft of the long head of the biceps tendon. This technique can offer a simple, replicable, and cost-effective autologous tendon patch augmentation after subscapularis tenotomy in the setting of total shoulder arthroplasty.