Inclusion Criteria:  Patients healthy enough to undergo primary anatomic TSA Being treated with subscapularis tenotomy or subscapularis peel. Age 50 or above Intact rotator cuff including subscapularis as determined by preoperative examination and imaging (typically preoperative CT, MRI if indicated or available).  Exclusion Criteria:  Revision arthroplasty Reverse arthroplasty Requiring a lesser tuberosity osteotomy Intraoperative identification of rotator cuff tear requiring repair Object to using cow derived material Prior index shoulder surgery requiring treatment to the subscapularis