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Updated: Jun 17, 2025
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Tendon Transfers in Reverse Total Shoulder Arthroplasty: A Systematic Review
Eric S Warren1, Eoghan T Hurley, Mikhail A Bethell
1From the Duke University School of Medicine, Duke University, Durham, NC (Dr. Warren and Dr. Bethell); the Department of Orthopaedic Surgery, Duke University, Durham, NC (Dr. Hurley, Dr. Klifto, and Dr. Anakwenze); the Department of Orthopedics, Atrium Health, Charlotte, NC (Dr. Loeffler and Dr. Hamid); and the OrthoCarolina Hand Center, Charlotte, NC (Dr. Loeffler and Dr. Hamid).
Tendon transfers combined with reverse total shoulder arthroplasty (RTSA) significantly improve shoulder function and patient satisfaction. However, a moderate complication rate of 11.3% warrants consideration.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Research
- Biomechanical Engineering
Background:
- Reverse total shoulder arthroplasty (RTSA) is a common procedure for complex shoulder pathologies.
- Tendon transfers are sometimes necessary to restore function after RTSA.
- Evaluating outcomes of tendon transfers in RTSA is crucial for optimizing patient care.
Purpose of the Study:
- To systematically evaluate clinical outcomes following tendon transfers in patients who have undergone RTSA.
- To compare the effectiveness of different tendon transfer techniques.
Main Methods:
- A systematic review of PubMed and Embase databases was conducted.
- Studies included any type of tendon transfer in the setting of RTSA.
- Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed.
Main Results:
- Seventeen studies with 300 shoulders were analyzed, showing significant improvements in external rotation, flexion, and patient-reported outcomes (e.g., Constant score, VAS).
- Combined latissimus dorsi and teres major transfer (LDTM) and latissimus dorsi (LD) transfer alone both yielded positive results.
- The overall complication rate was 11.3%, with arthroplasty revision being the most common reason for reoperation (5.3%).
- Lateralized implants with tendon transfer showed greater improvements in some functional measures, while medialized implants favored others.
Conclusions:
- Tendon transfers, including combined LDTM or LD alone, in RTSA lead to substantial improvements in subjective and functional outcomes.
- A moderate incidence of complications (11.3%) was observed, highlighting the need for careful patient selection and management.
