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Pectoralis transfer for subscapularis insufficiency yielded poor long-term survivorship
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LAS VEGAS — Results presented at the American Academy of Orthopaedic Surgeons showed pectoralis transfer in patients with subscapularis insufficiency had poor long-term survivorship, despite being a good salvage option.
Michael D. Charles, MD, and colleagues collected demographics and operative data for 20 patients who underwent pectoralis transfer for irreparable tears or insufficiency of the subscapularis between 1999 to 2016.
“Our primary outcome was the time to failure, and that was defined as conversion to a reverse total shoulder,” Charles said in his presentation here. “Secondary outcomes included numerous patient-reported outcomes.”
Charles noted 40% of patients underwent revision to a reverse total shoulder arthroplasty at an average of 3.3 years postoperatively. He added that a higher number of surgeries prior to the pectoralis transfer was a significant risk factor for failure.
“In terms of our primary outcome, overall at 5 years, we had a 59% survival rate,” Charles said. “[At] 10 years, [this] was projected to be at 39.4%.”
Patients who underwent arthroplasty had a slightly better survival rate of 85% at 5 years and had a survival rate of 51% at 10 years, according to Charles.
For secondary outcomes, Charles noted most patients had mild to moderate chronic pain, as well as low functional and overall well-being scores. However, he noted patients had average mental health scores.
“Even when we looked at the patients who were successful and those who went on to conversion, there was no difference between these patient-reported outcomes,” Charles said. – by Casey Tingle
Reference:
Charles MD, et al. Abstract 203. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 12-15, 2019; Las Vegas.
Disclosure: Charles reports no relevant financial disclosures.