Ten patients were treated with LDT at a mean of 27 months (range, 4-134 months) after RTSA. Standard LDT was performed in 4 patients and a LDT plus teres major transfer according to L'Episcopo in 6 patients. All patients had preoperative and postoperative clinical evaluation, including the assessment of the Constant score and the subjective shoulder value.
RTSA increased the preoperative mean relative Constant score from 26% (range, 11%-67%) to 51% (range, 20%-100%; P = .05). At a mean of 49 months (range, 23-67 months) after additional LDT, the relative Constant score further increased to 58% (range, 34%-100%; P = .141), remaining significantly superior to the score before RTSA (P = .021). The mean subjective shoulder value was 15% (range, 0%-30%) before and 44% (range, 20%-70%) after RTSA (P = .273) and was 56% (range, 20%-90%) after LDT (P = .686), a significant overall improvement of the state of the shoulder compared with before RTSA (P = .042). Mean active flexion increased from 36° (range, 0°-130°) to 86° (range, 10°-140°) after RTSA (P = .024) and to 109° (range,70°-140°) after LDT (P = 0.017 compared with pre-LDT; P = .011 compared with pre-RTSA). Mean active external rotation decreased from 0° (range, –80° to 50)° to –18° (range, –50°to 10)° after RTSA (P = .079) and was improved to 2° (–40° to 40)° after LDT (P = .24 compared with pre-LDT; P=.865 compared with pre RTSA).
Secondary LDT significantly improves active mobility in patients with residual dysfunction after RTSA.