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Background: Subscapularis management with lesser tuberosity osteotomy (LTO) repair in stemless total shoulder arthroplasty (TSA) is particularly different in terms of suture fixation as opposed to stemmed humeral implants. Surgical techniques to achieve optimal soft tissue balance in LTO repairs differ based on the surgeon. The purpose of this study is to determine whether there is a difference in 2 years functional or clinical outcomes in stemless TSA patients treated with LTO repairs conducted with bone tunnels versus suture anchors. Methods: A retrospective review was performed of a prospectively maintained, multicenter database of primary TSAs performed by multiple surgeons between 2019 and 2023 with minimum 2-year follow-up. A total of 81 patients met the study criteria, including 33 in the suture anchor cohort versus 48 in the bone tunnel cohort. Patient-reported outcomes (PROs) as well as range of motion (ROM) measurements were compared between the 2 groups for baseline results as well as at two year follow-up. Conclusion: The current study suggests equivalent two year functional and clinical outcomes for patients treated with suture anchors versus the conventional bone tunnels in LTO repair for stemless TSA patients. The 2 groups had similar baseline demographics, ROM, and PRO scores and performed similarly at two years follow-up.
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Galal et al. (2026) studied this question.
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