Radiographic Study of Humeral Stem in Shoulder Arthroplasty After Lesser Tuberosity Osteotomy or Subscapularis Tenotomy

2018 ◽  
Vol 47 (5) ◽  
Author(s):  
Robert Mason ◽  
Taylor Buckley ◽  
Richard Southgate ◽  
Gregg Nicandri ◽  
Richard Miller ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Radiographic Study ◽  
Lesser Tuberosity ◽  
Subscapularis Tenotomy

Biomechanical comparison of lesser tuberosity osteotomy versus subscapularis tenotomy in total shoulder arthroplasty

2012 ◽  
Vol 21 (8) ◽  
pp. 1087-1095 ◽  
Author(s):  
Steven A. Giuseffi ◽  
Prasit Wongtriratanachai ◽  
Hiromichi Omae ◽  
Akin Cil ◽  
Mark E. Zobitz ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Lesser Tuberosity ◽  
Biomechanical Comparison ◽  
Subscapularis Tenotomy

Lesser tuberosity osteotomy and subscapularis tenotomy repair techniques during total shoulder arthroplasty: A meta-analysis of cadaveric studies

2016 ◽  
Vol 40 ◽  
pp. 33-36 ◽  
Author(s):  
John B. Schrock ◽  
Matthew J. Kraeutler ◽  
Darby A. Houck ◽  
Gina G. Provenzano ◽  
Eric C. McCarty ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty ◽  
Lesser Tuberosity ◽  
Subscapularis Tenotomy ◽  
Repair Techniques

scholarly journals Comparison of Subscapularis Management and Repair Techniques

2019 ◽  
Vol 3 ◽  
pp. 247154921984815 ◽  
Author(s):  
Robin Dunn ◽  
Christopher D Joyce ◽  
Jonathan T Bravman
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Subscapularis Tendon ◽  
Lesser Tuberosity ◽  
Crucial Step ◽  
Optimal Strength ◽  
Subscapularis Tenotomy ◽  
Repair Techniques

Management of the subscapularis tendon is a crucial step during the approach for total shoulder arthroplasty. The method of mobilizing the tendon and the technique used to repair it determine the initial integrity of the subscapularis and impact its capacity to heal. Currently, there exist 3 well-described and well-studied approaches to managing and repairing the subscapularis: subscapularis tenotomy, subscapularis peel, and lesser tuberosity osteotomy. More recently, a subscapularis-sparing approach has been proposed as an option. There is debate in the literature regarding which technique provides optimal strength and stability for subscapularis repair following shoulder arthroplasty. In this symposium, we provide an overview of each of the techniques and review the biomechanical studies comparing them.

scholarly journals Lesser Tuberosity Osteotomy in Anatomic Total Shoulder Arthroplasty

2018 ◽  
Vol 2 ◽  
pp. 247154921880971
Author(s):  
Alexander Martusiewicz ◽  
Jay D Keener
Keyword(s):  
Surgical Technique ◽  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Lesser Tuberosity ◽  
Significant Variability ◽  
Subscapularis Tenotomy ◽  
Repair Techniques

The deltopectoral exposure has earned the reputation as the “workhorse” approach to the shoulder. Due to the reproducible anatomy and its extensile nature, there is little debate when considering exposure in total shoulder arthroplasty (TSA). Despite this consensus, there is still significant variability in management of the subscapularis. Several repair techniques including a subscapularis tenotomy, peel, and lesser tuberosity osteotomy (LTO) have been developed to ensure healing and optimize function. This article focuses on performing a LTO in anatomic TSA. We will review the surgical technique and advantages in exposure in addition to biomechanical and clinical outcomes.

scholarly journals Treatment Outcomes of Lesser Tuberosity Osteotomy Nonunion After Total Shoulder Arthroplasty

2018 ◽  
Vol 2 ◽  
pp. 247154921880777
Author(s):  
Zachary J Bloom ◽  
Cesar D Lopez, BA ◽  
Stephen P Maier ◽  
Brian B Shiu ◽  
Djuro Petkovic ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Shoulder Arthroplasty ◽  
Surgical Repair ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Radiographic Evaluation ◽  
Lesser Tuberosity ◽  
Conservative Care ◽  
Conservative Group

Introduction Lesser tuberosity osteotomy (LTO) during anatomic total shoulder arthroplasty has a 13% nonunion rate. Treatment for LTO nonunion is controversial and poorly described in the literature. The purpose of this study was to compare the surgical and nonsurgical treatment outcomes of LTO nonunion. Methods A retrospective case series of 9 consecutive patients with LTO nonunion after primary anatomic shoulder arthroplasty at 1 institution from 2010 to 2016 were studied. Outcomes measured were radiographic evaluation of LTO on axillary X-ray, clinical range of motion (ROM), subscapularis strength, and pain at the time of LTO nonunion diagnosis and after either conservative care or surgical repair of the LTO nonunion. Results LTO nonunion was treated surgically in 4 and conservatively in 5 patients with average follow-up of 30 and 22 months, respectively. There were no significant differences in age, sex, or smoking status between groups. Treatment decision was a shared model of surgeon and patient. Displaced LTO nonunion was treated surgically in 2 and conservatively in 3 patients. There were no differences in LTO union rate of 50% in the surgical versus 60% in the conservative group. Abdominal compression test was abnormal in 50% of surgical versus 40% of conservative groups. At follow-up, ROM was lower in the surgical group with 128° forward elevation (FE) and 33° external rotation (ER) compared to 148° FE and 62° ER. Only 1 patient with LTO nonunion required conversion to reverse replacement. Conclusion LTO nonunion after shoulder arthroplasty is rare. Surgical repair of LTO nonunion does not significantly improve clinical or radiographic outcomes compared to conservative care.

Sign in / Sign up

Export Citation Format

Share Document