title: Humeral resurfacing arthroplasty in combination with latissimus dorsi tendon transfer in patients with rotator cuff tear arthropathy and preserved subscapularis muscle function: preliminary report and short-term results.
abstract: OBJECTIVE
  Humeral resurfacing arthroplasty represents an alternative option to hemiarthroplasty for treatment of cuff tear arthropathy (CTA), with the advantages as follows: suitability for relatively young and high-demand patients because of preservation of bone stock and no loss of length, less invasive surgery, shorter operation time, no risk of periprosthetic stem fractures, and revision surgery can be undertaken easily. In the current study, resurfacing arthroplasty in combination with latissimus dorsi tendon transfer for CTA was performed. Three hypotheses: first, humeral resurfacing arthroplasty in combination with latissimus dorsi tendon transfer would improve the overall functional outcome in patients with CTA. Second, this combination would improve humeral external rotation. Third, this combination would improve abduction and shoulder elevation.
  
  
  METHODS
  Study was conducted as an observational case series. Fourteen patients (nine ♀ and five ♂) having CTA were included. Follow-up was carried out at the end of the 28th month for all patients. Constant Score was used for follow-up evaluation. Dorso-axillary approach was used for latissimus dorsi tendon transfer and ventral deltopectoral approach for Copeland resurfacing. Tendons were fixed to the greater tuberosity with two anchors.
  
  
  RESULTS
  The absolute Constant Score significantly improved from 34 preoperatively to 69 postoperatively, relative Constant Score from 42 to 91%, elevation from 95° to 138°, abduction from 88° to 147°, and external rotation from 16° to 22° (not significant).
  
  
  CONCLUSIONS
  Humeral resurfacing arthroplasty in combination with latissimus dorsi tendon transfer in patients having CTA with preserved subscapularis function has satisfactory short-term functional clinical outcome.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopedics, Trauma Surgery and Sports Medicine, Johanna Etienne Hospital, AM Hasenberg 46, 41462, Neuss, Germany, j.jerosch@ak-neuss.de.
authors.forename: Joerg
authors.initials: J
authors.lastname: Jerosch
authors.forename: Sherif M
authors.initials: SM
authors.lastname: Sokkar
authors.forename: Christian
authors.initials: C
authors.lastname: Neuhaeuser
authors.forename: Ashraf
authors.initials: A
authors.lastname: Abdelkafy
mesh_terms: D000368:Aged; D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods*; D064131:Back Muscles / Q000502:physiology; D005260:Female; D006801:Humans; D058430:Humeral Head / Q000601:surgery; D007592:Joint Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D012399:Rotation; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology; D064171:Superficial Back Muscles; D013710:Tendons / Q000637:transplantation; D013997:Time Factors