scholarly journals Osseous changes following reverse total shoulder arthroplasty combined with latissimus dorsi transfer: a case series

2020 ◽  
Vol 4 (4) ◽  
pp. 964-968
Author(s):  
Jason S. Klein ◽  
Peter S. Johnston ◽  
Benjamin W. Sears ◽  
Manan S. Patel ◽  
Armodios M. Hatzidakis ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Latissimus Dorsi ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Reverse Total Shoulder Arthroplasty ◽  
Latissimus Dorsi Transfer ◽  
Osseous Changes ◽  
Reverse Total Shoulder

Mid-term outcomes after reverse total shoulder arthroplasty with latissimus dorsi transfer

2021 ◽  
pp. 175857322199634
Author(s):  
Akshar V Patel ◽  
Douglas J Matijakovich ◽  
Robert L Brochin ◽  
Ryley K Zastrow ◽  
Bradford O Parsons ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Latissimus Dorsi ◽  
External Rotation ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
P Value ◽  
Latissimus Dorsi Transfer ◽  
Reverse Total Shoulder

Background Reverse total shoulder arthroplasty is a common treatment for patients with rotator cuff arthropathy who have failed a prior rotator cuff repair. Latissimus dorsi transfer can be performed simultaneously to reverse total shoulder arthroplasty for patients with preoperative external rotation deficiency. Current literature is limited with several studies providing functional and pain improvements at short-term follow-up; however, there is a deficit in data regarding mid-term outcomes. The purpose of this study was to evaluate the clinical and radiographic outcomes following reverse total shoulder arthroplasty with latissimus dorsi transfer with mid-term follow-up. We hypothesized significant improvement in external rotation and shoulder functionality for patients with preoperative external rotation lag. Methods We retrospectively reviewed patients who underwent reverse total shoulder arthroplasty with latissimus dorsi transfer. Preoperative and postoperative changes in range of motion were assessed. American Shoulder and Elbow Surgeon Score and the Simple Shoulder Test were used to evaluate changes in shoulder function while pain scores were assessed using the Visual Analog Scale (VAS). Radiographs were reviewed for rotator cuff arthropathy, fatty infiltration, scapular notching, baseplate loosening, and osteolysis. We reported frequency and mean ± standard deviation for categorical and continuous variables, respectively. Means were compared using the paired Student's t-test and proportions using the Chi-square test. Results Fifteen patients met the inclusion criteria. The mean age of the cohort was 71.7 ± 8.4 years (range 51.2–87.8 years) with a mean follow-up of 6.3 ± 4.1 years (range 1.0–14.5 years). Reverse total shoulder arthroplasty with latissimus dorsi transfer improved external rotation (−7 ± 21.3° to 38 ± 15.8°; p value = 0.001). There was no statistically significant difference regarding forward flexion (116.3 ± 45.4° to 133.7 ± 14.7°; p value = 0.17) and internal rotation (T12 to L2; p value = 0.57). The procedure led to an increase in American Shoulder and Elbow Surgeon Score scores (37 ± 19 to 62 ± 22; p = 0.005) and Simple Shoulder Test scores (2 ± 2 to 6 ± 3; p value = 0.001) with a significant reduction in Visual Analog Scale scores (5 ± 3 to 2 ± 3; p value = 0.022). The procedure corrected external rotation lag in 10 patients. Radiographically, rotator cuff arthropathy was found to be grade 3 in two patients, grade 4 A in four patients, grade 4B in eight patients, and grade 5 in one patient. On postoperative imaging, scapular notching was found in six patients (40%). Twelve patients had cortical humeral erosion at the site of the latissimus dorsi transfer. Only one patient experienced a shoulder-related complication which was aseptic baseplate loosening and required a revision reverse total shoulder arthroplasty with allograft. Conclusions In this study, patients undergoing reverse total shoulder arthroplasty with latissimus dorsi transfer experienced improvements in range of motion, functional scores, and pain at mid-term follow-up. The shoulder-related complication rate was low. Level of evidence: IV; Case series.

Management of deep infection after reverse total shoulder arthroplasty: a case series

2012 ◽  
Vol 21 (10) ◽  
pp. 1310-1315 ◽  
Author(s):  
John A. Zavala ◽  
J.C. Clark ◽  
Michael J. Kissenberth ◽  
Stefan J. Tolan ◽  
Richard J. Hawkins
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Deep Infection ◽  
Reverse Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder

scholarly journals Analysis of complications of reverse total shoulder arthroplasty

Joints ◽  
2015 ◽  
Vol 03 (02) ◽  
pp. 62-66 ◽  
Author(s):  
Raffaele Russo ◽  
Giuseppe Rotonda ◽  
Michele Ciccarelli ◽  
Fabio Cautiero
Keyword(s):  
Shoulder Arthroplasty ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Reverse Total Shoulder Arthroplasty ◽  
Fracture Group ◽  
Long Thoracic Nerve ◽  
Secondary Osteoarthritis ◽  
Humeral Component ◽  
Reverse Total Shoulder

Purpose: the aim of this study was to analyze complications of reverse total shoulder arthroplasty (RTSA) used to treat different shoulder diseases. Methods: from March 2000 to March 2013, 195 RTSA were implanted by the senior Author. The indications for reverse prosthesis surgery were secondary osteoarthritis (OA) in 49 cases, irreparable rotator cuff tear (RCT) in 48 cases, and complex humeral fractures in 75 cases, while 19 were patients requiring surgical revision for first prosthesis implant. We used different prostheses with different designs. Results: the clinical and radiological results of all the patients were analyzed retrospectively at an average follow-up of 7 years. The cases were divided into four groups on the basis of the diagnosis and complications were classified as perioperative, postoperative, or late. The mean total Constant score improved from 28 to 69 points in the OA group; from 21 to 70.8 points in the irreparable RCT group, to 76.4 in the fracture group, and from 16.6 to 59.8 points in the revision group. Scapular notching was observed in 59 cases (30.2%). Thirty-three other complications (16.9%) were observed, namely: hematomas (n=3), instability of the humeral component (n=1), scapular spine fractures (n=2), ulnar nerve deficit (n=2), long thoracic nerve palsy (n=2), deep infections (n=2), periprosthetic fractures (n=6), glenoid fractures (n=2), implant loosening (n=2), anterior deltoid muscle deficiency (n=2) and periarticular heterotopic calcifications (n=9). Conclusions: the rates of complications, especially fractures, reported in the present study were lower than those reported in the current literature. Level of evidence: Level IV, therapeutic case series.

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