Uncemented vs. cemented reverse total shoulder arthroplasty with latissimus dorsi and teres major transfer

Reverse total shoulder arthroplasty (rTSA) combined with latissimus dorsi and teres major (LD/TM) transfer is an effective treatment for massive rotator cuff tears associated with deficits in elevation and external rotation. The humeral components of rTSA can be implanted using either a cemented or uncemented technique; however, the impact of the fixation method on postoperative clinical outcomes remains unclear. The primary aim of this study was to compare the clinical outcomes of cemented or uncemented fixation of the humeral component in rTSA with LD/TM transfer with a minimum follow-up of 2 years. We hypothesized the fixation methods would influence the postoperative radiological findings but not the postoperative clinical outcomes.

A total of 32 shoulders with rotator cuff tear and deficits in elevation and external rotation underwent rTSA with LD/TM transfer with either cemented (C group) or uncemented (unC group) humeral component. Postoperative clinical outcomes were evaluated based on the range of motion, the American Shoulder and Elbow Surgeons score, and the Constant-Murley score. Clinical and radiological outcomes were compared between the groups, and their progression over time was analyzed.

Both groups demonstrated significant postoperative improvements in range of motion, American Shoulder and Elbow Surgeons score, and Constant-Murley score, with no significant differences between the groups. However, bone resorption at the tendon insertion site was more prominent in the unC group than in the C group. Clinical outcomes stabilized after 6 months, and radiological findings showed no further changes beyond 12 months. No periprosthetic fractures were observed.

In patients treated with rTSA with LD/TM transfer, severe bone resorption at the tendon insertion site was more frequently observed in the patients treated with uncemented humeral implants than those with cemented ones.