Reverse Shoulder Arthroplasty and Latissimus Dorsi Tendon Transfer

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Cuff tear arthropathy and teres minor dysfunction often lead to significant shoulder disability.
• Reverse shoulder arthroplasty (RSA) is a common treatment, but restoring external rotation can be challenging.

Purpose of the Study:

• To systematically review and synthesize evidence on the efficacy and safety of combining RSA with latissimus dorsi tendon transfer.
• To evaluate functional outcomes and complication rates of this combined surgical approach.

Main Methods:

• A systematic review of studies from two electronic databases.
• Inclusion of seven studies involving 133 patients.
• Quality assessment of included studies by two independent reviewers.
• Frequency-weighted (FW) mean values used for data synthesis.

Main Results:

• Significant improvement in the Constant score from an FW mean of 28.7 to 64.4 (P = .0001).
• Significant improvement in external rotation from an FW mean of -4° to 25° (P < .0001).
• An overall complication rate of 22.8% was observed.

Conclusions:

• Reverse shoulder arthroplasty with latissimus dorsi tendon transfer effectively enhances shoulder function and external rotation in patients with specific rotator cuff deficiencies.
• The complication profile appears similar to RSA alone, although neuropraxia may be more frequent.