International Orthopaedics | 2021
Mid- to long-term outcomes after reverse shoulder arthroplasty with latissimus dorsi and teres major transfer for irreparable posterosuperior rotator cuff tears
Abstract
The objective of this study was to describe the outcome of reverse shoulder arthroplasty (RSA) combined with modified L’Episcopo procedure at long-term follow-up (5 to 12 years). A retrospective review of 17 RSAs (mean age 67.2 years) with the modified L’Episcopo procedure conducted 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 five years (mean 97.3 months). Outcome measures included range of motion, subjective shoulder value (SSV), visual analogue scale (VAS), and Constant-Murley scores. All patients (16) demonstrated a significant improvement in all clinical and functional parameters. VAS pain scores improved from 6\u2009±\u20092.6 to 1\u2009±\u20091; SSV improved from 35\u2009±\u200914 to 72\u2009±\u200910; active forward elevation increased from 66°\u2009±\u200934 to 125°\u2009±\u200929; and active external rotation arm at the body increased from −11°\u2009±\u200922 to 21° ±11 and in 90° of abduction from −10°\u2009±\u200917 to 37°\u2009±\u200924. The mean Constant score improved from 25\u2009±\u200911 to 59\u2009±\u20098. Active internal rotation did not significantly change (p\u2009=\u20090.332). 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.