Reverse Total Shoulder Arthroplasty with Concurrent Latissimus Dorsi Tendon Transfer

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Reverse total shoulder arthroplasty (rTSA) is effective for rotator cuff arthropathy.
• Functional deficits in abduction and external rotation may persist post-rTSA.
• Latissimus dorsi tendon transfer (LDTT) is a potential supplemental procedure.

Purpose of the Study:

• To review the role of LDTT in conjunction with rTSA.
• To critically evaluate evidence on functional improvements from supplemental LDTT.

Main Methods:

• Review of existing literature on rTSA and LDTT.
• Analysis of studies comparing rTSA with and without LDTT.
• Evaluation of patient function and reported outcomes.

Main Results:

• rTSA improves external rotation in patients with intact rotator cuffs.
• rTSA with LDTT shows significant improvements in active external rotation compared to baseline.
• A randomized trial found no significant difference between rTSA with and without LDTT.
• Observational studies report improvements with rTSA and LDTT, but direct comparisons lack statistical significance.

Conclusions:

• Current literature does not demonstrate a significant advantage of LDTT over rTSA alone for short-term outcomes.
• Further randomized controlled trials are needed to clarify the benefits of supplemental LDTT in rTSA.