Concomitant Latissimus Dorsi Tendon Transfer during Reverse Total Shoulder Arthroplasty Does Not Improve Active External Rotation or Clinical Outcomes in Patients with External Rotation Deficit.
Journal of Shoulder and Elbow Surgery
PURPOSE: To assess the role of latissimus dorsi tendon transfer concomitant with reverse total shoulder arthroplasty in patients with external rotation deficit secondary to severe rotator cuff deficiency with and without glenohumeral arthritis.
METHODS: Patients with a positive external lag sign and(aER) treated with reverse shoulder arthroplasty (RTSA) at a single institution with a minimum 12 month follow-up were retrospectively identified from a prospective database. Basic demographic information along with preoperative and postoperative range of motion (ROM) measures, American Shoulder and Elbow Surgeons score (ASES), visual analog scale pain (VAS), and Subjective Shoulder Value (SSV) scores were obtained. Statistical analysis was performed to compare ROM and functional outcomes between patients that underwent concomitant LDT and those with no transfer.
RESULTS: The latissimus dorsi transfer (LDT [n=31]) and no transfer (NT [n=33]) groups had similar age, sex distributions, and follow-up length average (24 vs 30 months). No differences were found between groups at baseline, final follow-up, or magnitude of change for ASES, VAS pain, and SSV scores. Baseline ROM measures were similar, except for the LDT group having slightly less aER (-8 ⁰ vs 0⁰; P=0.004). In addition, all postoperative ROM measures including aER were similar, except for a slight improvement in active internal rotation (IR) in the NT group. The majority of patients were satisfied with their outcome (LDT 84% (n=26); NT 87% (n=27); P=0.72).
CONCLUSION: Patients with external rotation deficit secondary to severe rotator cuff deficiency with and without glenohumeral arthritis undergoing RTSA do not have significantly improved external rotation or patient reported outcome measures with LDT.
Wiater JM, Oshikoya O, Shields E, Vara AD, Cavinatto L, Koueiter DM. Concomitant latissimus dorsi tendon transfer during reverse total shoulder arthroplasty does not improve active external rotation or clinical outcomes in patients with external rotation deficit. J Shoulder Elbow Surg. 2023 May:32(5):1016-1021. doi: 10.1016/j.jse.2022.11.011. PMID: 36565740.