Outcomes after Reverse Shoulder Arthroplasty with Latissimus Dorsi and Teres Major Transfer for Deficient Active Elevation and External Rotation. Results Evolution in Time
2Orthpaedic Surgery, Mayo Clinic, Jacksonville, Florida 32224, USA
3Orthopedic Devision, Tel-Aviv Sourasky Medical Center, Weizmann St 6 , 6423906 Tel-Aviv, Israel
Aim:
The objective of this study was to describe the outcome of RSA combined with modified l’Episcopo procedure at long-term follow-up (5 to 12 years) .
Methods:
A retrospective review of 17 RSAs (mean age 67.2 years) with the modified l’Episcopo procedure performed between 2006 and 2016 was performed. All patients had a combined loss of active elevation and external rotation with an irreparable posterosuperior rotator cuff tear. Clinical assessment was performed with a minimum follow-up of 5 years (mean 97,3 months). Outcome measures included range of motion, SSV, VAS, and Constant-Murley scores.
Results:
All patients (16) demonstrated a significant improvement in all clinical and functional parameters. VAS pain scores improved from 6±2.6 to 1±1; SSV improved from 35±14 to 72±10; active forward elevation increased from 66°±34 to 125°±29; active external rotation arm at the body -11°±22 to 21° ±11 and in 90° of abduction from -10°±17 to 37°±24. The mean Constant score improved from 25±11 to 59±8. Active internal rotation did not significantly change ((p= 0.332).
Conclusion:
At long-term follow-up, RSA combined with modified l’Episcopo procedure resulted in significant improvements in pain, range of motion and functional scores for patients with shoulder pseudoparalysis and a lack of active external rotation caused by a massive posterosuperior cuff tear with a teres minor deficiency .