Longitudinal observational study of reverse total shoulder arthroplasty for irreparable rotator cuff dysfunction: results after 15 years

Gerber, Christian; Canonica, Sandro; Catanzaro, Sabrina; Ernstbrunner, Lukas

doi:10.1016/j.jse.2017.10.037

Cited by 122 publications

(90 citation statements)

References 21 publications

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“…If the RCT involves the posterosuperior cuff, typical functional deficits are weakness of abduction and external rotation with diminished overhead function [7, 8••]. However, the clinical presentation of patients with posterosuperior mRCTs can vary widely from slight weakness and pain to pseudoparesis or even paralysis (PP) [9][10][11] with loss of control of the arm in space [12,13]. The hallmarks of chronic RCTs are atrophy [14], fatty infiltration [15], and myotendinous retraction [16], which can be assessed and quantified on MRI-or CT arthrography.…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Massive Irreparable Cuff Tears: Latissimus Dorsi Transfer for Posterosuperior Tears

Wieser

Ernstbrunner

Zumstein

2020

Curr Rev Musculoskelet Med

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Purpose of Review This review aims to describe the role of the latissimus dorsi transfer (LDT) for patients with irreparable posterosuperior rotator cuff tears (RCTs). Recent Findings Historically, the LDT has been performed as an open (double-incision) procedure for neurologically intact, relatively young patients with irreparable posterosuperior RCTs with disabling loss of active external rotation with or without impaired active elevation. The transferred tendon reconstitutes the posterior rotator cuff and force couple, respectively and thus has the potential to function effectively as an external rotator and humeral head depressor. Long-term results of the open technique have demonstrated in the majority of patients substantial and durable improvements in shoulder function and pain relief at the 10-year benchmark. With the advancements of arthroscopic surgery, the LDT was expanded to an arthroscopically assisted procedure with promising short-term results. In addition to adequate technical performance, the success of the procedure depends on preoperative factors, such as exclusion of glenohumeral osteoarthritis and acromial acetabularization; intact or reparable subscapularis tendon; intact (or hypertrophic) teres minor muscle; adequate preoperative activity of the latissimus dorsi; and normal or mild impairment of overhead function. Summary The LDT (open or arthroscopically assisted) is a reliable treatment option for patients with massive, irreparable posterosuperior RCTs with disabling loss of active external rotation, with or without diminished overhead function and without advanced glenohumeral osteoarthritis. Precise patient selection is of tremendous importance in the success of the LDT.

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Section: Introductionmentioning

confidence: 99%

Surgical Management of Massive Irreparable Cuff Tears: Latissimus Dorsi Transfer for Posterosuperior Tears

Wieser

Ernstbrunner

Zumstein

2020

Curr Rev Musculoskelet Med

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“…Ist die RM-Ruptur irreparabel und der Funktionsanspruch des Patienten hoch, ist je nach Typ der Läsion die Indikation entweder für einen Muskel-Sehnen-Transfer, die Implantation einer inversen Schultertotalprothese [50] oder die Kombination aus beidem zu prüfen [51]. Folgende Muskel-Sehnen-Einheiten werden zur Kompensation von Elevation und Aussenrotationsschwäche bei vorliegender posterosuperioren RM-Ruptur (Supraspinatus und Infraspinatus, ggf.…”

Section: Chirurgische Therapieunclassified

“…Diese Patienten qualifi zieren in diesen Fällen für die Implantation einer in- versen Schulterprothese [58]. Die Schulterfunktion und die Lebensqualität können bei diesen Pa tienten wesentlich und auch langfristig verbessert werden [50]. Bei Patienten mit schlechten biologischen Grundvoraussetzungen ist die Chance für erfolgreiche Sehnenheilung geringer.…”

Section: Chirurgische Therapieunclassified

Rotatorenmanschettenruptur: Wann ist die konservative und wann die operative Therapie indiziert?

Wieser

Bouaicha

Grubhofer

2019

Praxis

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Zusammenfassung. Patienten mit Rotatorenmanschettenrupturen können konservativ oder operativ behandelt werden. Welche Behandlung gewählt wird, hängt einerseits von patientenspezifischen Faktoren wie Leidensdruck, körperliche Einschränkung, Aktivitätsniveau und Funktionsanspruch ab und andererseits von morphologischen/radiologischen Gegebenheiten wie Grösse der Sehnenruptur, Degeneration und Verfettung der Rotatorenmanschettenmuskulatur sowie Begleitverletzungen. Dieser Artikel beleuchtet die Hintergründe der Indikationsstellung für die konservative und operative Behandlung von Patienten mit Rissen der Rotatorenmanschette unter Einbezug klinischer und radiologischer Kriterien.

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“…Reverse total shoulder arthroplasty (RTSA) is a common treatment for massive rotator cuff deficiency associated with glenohumeral arthritis. It has shown favorable clinical results in short‐ and mid‐term studies, but there is considerable concern about the high revision rates (5%‐33%) at long‐term follow‐up 1‐9 . Numerous studies have shown that aseptic glenoid loosening is one of the main reasons for implant failure, and has been associated with between 10% and 100% of prosthesis revision 1,6,9‐11 .…”

Section: Introductionmentioning

confidence: 99%

Effect of stress‐shielding‐induced bone resorption on glenoid loosening in reverse total shoulder arthroplasty

Zhang

Grégory

Hansen

et al. 2020

Journal Orthopaedic Research

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Aseptic loosening of the glenoid component is one of the main reasons for the high revision rates of reverse total shoulder arthroplasty (RTSA). It has been reported that the bulky implant designs may lead to stress shielding. However, it is uncertain whether the shielding effect is severe enough to lead to bone resorption and glenoid loosening. The purpose of this study was to evaluate the level of stress‐shielding and assess whether bone resorption plays a role in aseptic glenoid loosening following RTSA. A cadaveric in vitro test model was used to validate a finite element model (FEM) of the scapula. The FEM of the scapula, incorporating adaptive bone remodeling algorithms, was used to predict changes in postoperative bone density after RTSA. Changes in bone strength after implantation were also analyzed. The strain values predicted from the FEM of the scapula were in agreement with the in vitro measurements. Analysis of postoperative bone adaptation revealed that strain‐induced bone resorption began at the peg of the implant and around the resected bone surface and then gradually expended to the peripheral regions. The bone strength also reduced postoperatively and appeared particularly around the implant peg. Strain‐induced bone resorption is a likely source of the bone loss commonly observed in RTSA. The finite element glenoid bone remodeling simulation may be used as a tool to evaluate glenoid implant design.

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Longitudinal observational study of reverse total shoulder arthroplasty for irreparable rotator cuff dysfunction: results after 15 years

Cited by 122 publications

References 21 publications

Surgical Management of Massive Irreparable Cuff Tears: Latissimus Dorsi Transfer for Posterosuperior Tears

Surgical Management of Massive Irreparable Cuff Tears: Latissimus Dorsi Transfer for Posterosuperior Tears

Rotatorenmanschettenruptur: Wann ist die konservative und wann die operative Therapie indiziert?

Effect of stress‐shielding‐induced bone resorption on glenoid loosening in reverse total shoulder arthroplasty

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