Reverse Shoulder Arthroplasty for Rotator Cuff Tears with and Without Prior Failed Repair: A Comparative Analysis

2021 ◽  
Vol 30 (7) ◽  
pp. e455
Author(s):  
Alexander J. Vervaecke ◽  
Andrew D. Carbone ◽  
Jashvant Poeran ◽  
Nicole Zubizarreta ◽  
Bradford O. Parsons ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Tears

scholarly journals Long-term outcome of arthroscopic debridement of massive irreparable rotator cuff tears

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241277
Author(s):  
Tim Vogler ◽  
Dimosthenis Andreou ◽  
Georg Gosheger ◽  
Nico Kurpiers ◽  
Clara Velmans ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Arthroscopic Debridement ◽  
Radiographic Outcome ◽  
Vas Score ◽  
Long Term Follow Up

Objectives To evaluate the clinical and radiographic outcome of low-demand patients with massive rotator cuff tears undergoing arthroscopic debridement in mid- and long-term follow-up, as well as the rate of conversion to reverse shoulder arthroplasty. Methods We performed a retrospective analysis of 19 patients with a mean age at surgery of 68 years (range, 55–80 years) from a previously described consecutive cohort and after a mean follow up of 47 month (FU1) and 145 month (FU2). The functional outcome was evaluated with the VAS score, the American Shoulder and Elbow Surgeons (ASES) score, and the age- and gender-adjusted Constant (aCS) score. The radiographic outcome was classified according to the Hamada classification. Non-parametric analyses were carried out with the Mann-Whitney U for independent samples and the Wilcoxon signed-rank test for related samples. Results Five patients (26%) developed symptomatic cuff tear arthropathy and underwent reverse shoulder arthroplasty after a mean time of 63 months (range, 45–97 months). These patients were excluded from further analyses. The mean VAS score of the remaining 14 patients at FU1 was significantly lower compared to preoperatively (P = .041), while there were no significant differences between the VAS score at FU1 and FU2 (P = 1.0). The ASES score of the affected shoulder at FU1 was significantly higher compared to prior to surgery (P = .028), while there were no significant differences between the scores of the affected shoulder between FU1 and FU2 (P = .878). While the ASES score of the contralateral shoulder at FU1 was significantly higher than the score of the affected shoulder (P = .038), there were no significant differences in the ASES scores of the affected and the healthy shoulder at FU2 (P = .575). The evaluation of the aCS produced similar results. A progression of the Hamada grade was documented in 6 patients. Conclusions Arthroscopic debridement is a safe and valid option for low-demand middle-age or elderly patients with symptomatic massive rotator cuff tears, leading to a significant pain relief and significantly improved functional outcome at mid- and long-term follow up. However, about a quarter of the patients in our cohort had to undergo reverse shoulder arthroplasty due to symptomatic cuff tear arthropathy. Furthermore, some of the remaining patients continued to undergo radiographic progression. This might be due to the natural history of their disease and/or the surgical procedure, and the clinical relevance of this finding should be evaluated in further studies.

Reverse Shoulder Arthroplasty after Failed Tendon Transfer for Irreparable Posterosuperior Rotator Cuff Tears

2021 ◽  
Author(s):  
Erick M. Marigi ◽  
Chelsea Harstad ◽  
Bassem Elhassan ◽  
Joaquin Sanchez-Sotelo ◽  
Karl Wieser ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Tendon Transfer ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Tears

scholarly journals Latissimus dorsi tendon transfers: a historical journey

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 9
Author(s):  
Ismail Turkmen ◽  
Emre Koraman ◽  
Oguz Poyanlı
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Latissimus Dorsi ◽  
Tendon Transfer ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Tendon Transfers ◽  
Technical Description

Several latissimus dorsi tendon transfer techniques for shoulder problems have been previously described and developed. These techniques involve the transfer in obstetric palsy, transfer in irreparable posterosuperior rotator cuff tears and subscapularis tears, and transfer in reverse shoulder arthroplasty. We detail the differences in planning and surgery and the need for different approaches. This historical and technical description provided in this study will benefit surgeons wishing to use the procedure.

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