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Reverse TSA with, without tendon transfer yields similar outcomes

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CHICAGO — A study presented at the American Shoulder and Elbow Surgeons Annual Meeting concluded there were no differences in functional outcomes among patients with shoulder pseudoparalysis and teres minor dysfunction who underwent reverse total shoulder arthroplasty either with or without concomitant latissimus dorsi and teres major tendon transfer.

Nady Hamid

Nady Hamid, MD, of OrthoCarolina Shoulder and Elbow Center in Charlotte, North Carolina, and colleagues randomly assigned 28 patients with concurrent shoulder pseudoparalysis and teres minor dysfunction to undergo reverse total shoulder arthroplasty (TSA) either with or without concomitant latissimus dorsi and teres major tendon transfer. At a minimum 1-year follow-up, investigators collected Activities of Daily Living and External Rotation (ADLER), DASH, ASES and simple shoulder test scores in both groups.

“Rehabilitation was standardized between the two groups with neural wedge sling and latissimus re-education physical therapy was used in the tendon transfer group,” Hamid said in his presentation.

ADLER, DASH, ASES and simple shoulder test scores showed no significant differences in functional outcomes following reverse TSA with or without concomitant latissimus dorsi and teres major tendon transfer, according to Hamid. He added there were no neurovascular complications or infections. However, Hamid noted one patient had postoperative instability that was successfully treated with polyethylene exchange.

“We did find that both groups, however, did show significant improvements in their ADLs requiring external rotation function as measured by the ADLER score,” Hamid said. “We feel that further research is needed to determine what role latissimus and teres major has in the setting for certain classes.” – by Scott Buzby

Reference:

Young BL, et al. Paper 12. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 12-14, 2018; Chicago.

Disclosure: Hamid reports he is a paid consultant for Biomet.