The "hidden lesion" refers to a tear of the subscapularis in the presence of an intact biceps pulley or rotator interval. Visualization of these tears during open surgery is difficult, yet even with the advancement of arthroscopy, visualization can still be challenging. Incomplete visualization of the subscapularis could lead to failure to diagnose a tear of the tendon and subsequently hinder results after shoulder surgery. With the advancement of arthroscopy, a technique to identify these hidden lesions is needed to avoid inferior results. We describe an arthroscopic technique to visualize, diagnosis, and repair these tears when clinically indicated. Implementing this technique in the setting of suspected subscapularis tendon injury can provide complete visualization of the tendon insertion.
Neyton L, Daggett M, Kruse K, Walch G. The Hidden Lesion of the Subscapularis: Arthroscopically Revisited. Arthroscopy Techniques. 2016; 5(4). doi: 10.1016/j.eats.2016.04.010.