Clinical Outcomes of Reverse Shoulder Arthroplasty Combined with Latissimus Dorsi Tendon Transfer

Abstract Background Reverse shoulder Arthroplasty (RSA) was first described by Paul Grammont in the mid-1980s. Classically, RSA has been used for cuff tear arthropathy in an elderly patient population. Since then, the indications for RSA have expanded, and it is now used for a variety of indications. RSA has been reported to restore abduction and anterior flexion in cuff deficient shoulders, but it does not improve active external rotation. Objective The functional outcome of Reverse Shoulder Arthroplasty with Latissmus dorsi tendon transfer as regards Range of Motion especially External Rotation during early Follow up and to determine its clinical importance. Patients and Methods This randomized study was conducted on 15 patients with shoulder osteoarthritis with rotator cuff deficiency promoted to have reverse shoulder arthroplasty with latissmus dorsi tendon transfer aged from 40 to 70 years old at Ain Shams University hospitals for 24 months duration. Results In our study, the constant score at 6 weeks postoperative ranged from 91 to 98, with a mean±SD of 93.47±2.39. The high constant score indicates a favorable overall functional outcome for the patients. In our study, no complications related to the surgery were observed among the studied patients. These included iatrogenic radial nerve injury, iatrogenic axillary nerve injury, intraoperative fractures, component disengagement, infection rate, and scapular notching. The absence of these complications indicates the safety and effectiveness of the surgical procedure. In our study, operative time ranged from 40 to 72 minutes, with a mean±SD of 56.87±11.82 minutes. This indicates that the surgical procedure, Reverse Shoulder Arthroplasty with Latissmus dorsi tendon transfer, can be performed within a reasonable time frame. In our study, rate of dislocation (instability) ranged from 0 to 0 with a mean±SD of 0±0. Conclusion Our study demonstrates that Reverse Shoulder Arthroplasty with Latissmus dorsi tendon transfer is a viable surgical option for patients with shoulder osteoarthritis and rotator cuff deficiency. The procedure provides favorable functional outcomes, particularly in terms of range of motion, including external rotation. The absence of complications in our study further supports the safety and efficacy of this surgical approach. Further research with larger sample sizes and longer- term follow-up is warranted to confirm these findings and expand our understanding of the procedure’s outcomes.