Reverse Delta-III Total Shoulder Replacement Combined with Latissimus Dorsi Transfer

Gerber, Christian; Pennington, Scott D.; Lingenfelter, Erich J.; Sukthankar, Atul

doi:10.2106/jbjs.f.00955

Cited by 143 publications

(85 citation statements)

References 17 publications

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“…We found no significant functional deterioration over ten years, with the relative Reverse shoulder arthroplasty in younger patients 14 Constant score and SSV remaining above 70% and 60%, respectively at 2 to 5 years, 5 to 7 years and 7 to 10 years (Table 5).…”

Section: Clinical Resultsmentioning

confidence: 68%

Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years

Neukom

Catanzaro

et al. 2013

Journal of Shoulder and Elbow Surgery

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350

193

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Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years Ek, Eugene T H; Neukom, Lisa; Catanzaro, Sabrina; Gerber, Christian Abstract: BACKGROUND: The role of reverse shoulder arthroplasty (RTSA) in the relatively young individual is currently unclear. Our study evaluates the midterm to long-term results of RTSA for patients aged younger than 65 years with pseudoparalysis secondary to massive irreparable rotator cuff tears, with or without arthritis. METHODS: Between 1997 and 2006, 46 RTSAs (41 patients) were performed. Mean age was 60 years (range, 46-64 years). At the latest follow-up, 5 patients had died and 1 was lost, leaving 35 patients (40 shoulders) with a mean follow-up of 93 months (range, 60-171 months). RESULTS: The mean relative Constant score increased from 34% to 74% (P < .0001) and the subjective shoulder value improved from 23% to 66% (P < .0001). Significant improvements were seen in active forward elevation (72°to 119°), pain scores, and strength (P < .001). One or more complications occurred in 15 shoulders (37.5%), with 6 failures (15%) resulting in removal or conversion to hemiarthroplasty (3 with infection, 3 with glenoid loosening). Ten shoulders (25%) underwent partial or total component exchange, conversion to hemiarthroplasty, or removal. Of the 15 patients who developed complications, 9 did not require prosthesis removal or conversion and functional outcome and subjective shoulder value were similar to those with no complications (P > .4). CONCLUSION: RTSA in younger patients provides significant subjective improvement and substantial gain in overall function, which is maintained up to 10 years. Although the complication rate is high, most can be treated successfully without compromise to clinical outcome. However, it is imperative that the high complication rate is explained to patients, with the risks and benefits carefully considered. Conflict of interest/Disclaimer: Christian Gerber receives royalties from Zimmer Inc, which is related to the subject of this article. All other authors, their immediate family, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.Reverse shoulder arthroplasty in younger patients 2 ABSTRACT Background:The role of reverse shoulder arthroplasty (RTSA) in the relatively young individual is currently unclear. Our study evaluates the mid to long-term results of RTSA for patients less than 65 years with pseudoparalysis secondary to massive irreparable rotator cuff tears with or without arthritis. Methods:Between 1997 and 2006, 46 RTSAs (41 patients) were performed. Mean age was 60 years (range, 46-64). At latest follow-up, 5 patients had died and 1 was lost, leaving 35 patients (40 shoulders) with a mean follow-up of 93 months (range, 60-171). Results:Mean relative Constant score increased from 34% to 74% (p<0.0001) and subjective s...

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Section: Clinical Resultsmentioning

confidence: 68%

Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years

Neukom

Catanzaro

et al. 2013

Journal of Shoulder and Elbow Surgery

Self Cite

350

193

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“…Review of the literature suggests the reported gain in active external rotation after an isolated transfer of the LD is modest, but patient satisfaction remains high because the arm is stabilized by the transfer [1,2,18,23,30,35,47]. Gerber [19] has recently reported a similar series of patients treated with a LD transfer and reverse shoulder arthroplasty; his preliminary results suggested similar promise but demonstrated a lower gain in external rotation. In addition, the isolated LD tendon is often thin and fragile while harvesting of both LD/TM tendons provides a strong tendon unit, improving the ease and strength of the reattachment on the posterolateral part of the humerus.…”

Section: Discussionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty Combined with a Modified Latissimus Dorsi and Teres Major Tendon Transfer for Shoulder Pseudoparalysis Associated with Dropping Arm

Boileau

Chuinard

Roussanne

et al. 2008

Clinical Orthopaedics &Amp; Related Research

197

146

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Although a reverse shoulder arthroplasty (RSA) can restore active elevation in the cuff deficient shoulder, it cannot restore active external rotation when both the infraspinatus and teres minor muscles are absent or atrophied. We hypothesized that a latissimus dorsi and teres major (LD/TM) transfer with a concomitant RSA would restore shoulder function and activities of daily living (ADLs). We prospectively followed 11 consecutive patients (mean age, 70 years) with a combined loss of active elevation and external rotation (shoulder pseudoparalysis and dropping arm) who underwent this procedure. All had severe cuff tear arthropathy (Hamada Stage 3, 4, or 5) and severe atrophy or fatty infiltration of infraspinatus and teres minor on preoperative MRI or CT-scan.

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“…2,4,16,[21][22][23]26 Rates of RTSA have increased exponentially over the past decade, 8,17 and RTSA now comprises approximately one-third of all glenohumeral arthroplasty procedures and roughly one-fourth of arthroplasty-treated proximal humerus fractures. 20 This success has resulted in the rapid expansion of RTSA indications and application.…”

mentioning

confidence: 99%

Previous Rotator Cuff Repair is Associated with Inferior Clinical Outcomes after Reverse Total Shoulder Arthroplasty

Shields

Koueiter

Maerz

et al. 2018

Journal of Shoulder and Elbow Surgery

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Reverse Delta-III Total Shoulder Replacement Combined with Latissimus Dorsi Transfer

Abstract: In the presence of severe loss of active elevation and external rotation, combined latissimus dorsi transfer and reverse total shoulder arthroplasty can restore elevation and external rotation, at least in the short term.

Cited by 143 publications

References 17 publications

Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years

Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years

Reverse Shoulder Arthroplasty Combined with a Modified Latissimus Dorsi and Teres Major Tendon Transfer for Shoulder Pseudoparalysis Associated with Dropping Arm

Previous Rotator Cuff Repair is Associated with Inferior Clinical Outcomes after Reverse Total Shoulder Arthroplasty

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