Lack of elevation and external rotation in the shoulder: Reverse total shoulder arthroplasty combined with latissimus dorsi transfer to the humerus versus the greater tuberosity

Abstract

Background The purpose of this study was to prospectively compare clinical outcomes of reverse total shoulder arthroplasty (RTSA) combined with latissimus dorsi transfer by modified L’Episcopo (Group I) versus the greater tuberosity (Group II) in patients with lack of elevation and external rotation in the shoulder. Materials and methods Eighteen patients participated in the study. They were placed randomly into two groups of nine patients in each group. The results were evaluated prior to surgery and at the end follow-up. Results The average follow-up was 33.2 months. The mean ASES scores improved from 13 points to 79 in Group I and from 15 to 73 in Group II. The mean Constant shoulder scores improved from 19 to 66 in Group I and from 18 to 67 in Group II. Mean active elevation increased from 59° to 147° in Group I and from 58° to 148° in Group II. The mean external rotation scores increased from −43° to 7° in Group I and from −41° to 23° in Group II. Conclusion Comparing clinical outcomes and active elevation, there were no significant differences. The latissimus dorsi transfer to the greater tuberosity provided greater external rotation than did the modified L’Episcopo transfer.

Outcomes of Reverse Total Shoulder Arthroplasty with Latissimus Dorsi Tendon Transfer for External Rotation Deficit

“…We also completed a bias assessment using the methodological index for nonrandomized studies (MINORS) criteria 24 . See Supplementary Table for individual studies and MINORS scores 9-12,25-39 .…”