Uncemented vs. cemented reverse total shoulder arthroplasty with latissimus dorsi and teres major transfer

Q2 Medicine

JSES International Pub Date : 2025-09-01 DOI:10.1016/j.jseint.2025.05.033

Gaku Matsuzawa MD, PhD , Taku Hatta MD, PhD , Koichi Sasajima MD, PhD , Eiji Itoi MD, PhD , Toshitake Aizawa MD, PhD

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Abstract

Background

Reverse total shoulder arthroplasty (rTSA) combined with latissimus dorsi and teres major (LD/TM) transfer is an effective treatment for massive rotator cuff tears associated with deficits in elevation and external rotation. The humeral components of rTSA can be implanted using either a cemented or uncemented technique; however, the impact of the fixation method on postoperative clinical outcomes remains unclear. The primary aim of this study was to compare the clinical outcomes of cemented or uncemented fixation of the humeral component in rTSA with LD/TM transfer with a minimum follow-up of 2 years. We hypothesized the fixation methods would influence the postoperative radiological findings but not the postoperative clinical outcomes.

Methods

A total of 32 shoulders with rotator cuff tear and deficits in elevation and external rotation underwent rTSA with LD/TM transfer with either cemented (C group) or uncemented (unC group) humeral component. Postoperative clinical outcomes were evaluated based on the range of motion, the American Shoulder and Elbow Surgeons score, and the Constant-Murley score. Clinical and radiological outcomes were compared between the groups, and their progression over time was analyzed.

Results

Both groups demonstrated significant postoperative improvements in range of motion, American Shoulder and Elbow Surgeons score, and Constant-Murley score, with no significant differences between the groups. However, bone resorption at the tendon insertion site was more prominent in the unC group than in the C group. Clinical outcomes stabilized after 6 months, and radiological findings showed no further changes beyond 12 months. No periprosthetic fractures were observed.

Conclusion

In patients treated with rTSA with LD/TM transfer, severe bone resorption at the tendon insertion site was more frequently observed in the patients treated with uncemented humeral implants than those with cemented ones.

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背阔肌和大圆肌转移的非骨水泥与骨水泥反向全肩关节置换术

背景：逆行全肩关节置换术（rTSA）联合背阔肌和大圆肌（LD/TM）转移是一种有效的治疗与抬高和外旋缺陷相关的大量肩袖撕裂的方法。rTSA的肱骨组件可以采用骨水泥或非骨水泥技术植入；然而，固定方法对术后临床结果的影响尚不清楚。本研究的主要目的是通过至少2年的随访，比较rTSA中肱骨部件骨水泥或非骨水泥固定与LD/TM转移的临床结果。我们假设固定方法会影响术后放射学表现，但不会影响术后临床结果。方法对32例肩袖撕裂、抬高和外旋能力不足的肩胛骨，采用骨水泥（C组）或未骨水泥（unC组）肱骨假体进行LD/TM转移的rTSA治疗。术后临床结果根据关节活动度、美国肩关节外科医生评分和Constant-Murley评分进行评估。比较两组之间的临床和放射学结果，并分析其随时间的进展。结果两组患者术后活动范围、American Shoulder and Elbow Surgeons评分和Constant-Murley评分均有显著改善，两组间无显著差异。然而，unC组肌腱止点骨吸收比C组更明显。临床结果在6个月后稳定下来，12个月后影像学结果显示没有进一步的变化。未见假体周围骨折。结论在rTSA合并LD/TM转移的患者中，未骨水泥肱骨种植体比骨水泥肱骨种植体更容易出现肌腱止点严重的骨吸收。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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