Gerber et al. report a preliminary case series evaluating simultaneous reverse total shoulder arthroplasty and latissimus dorsi transfer in patients with combined pseudoparesis of both elevation and external rotation — a population in whom reverse arthroplasty alone consistently underperforms due to absent teres minor function.
When you see a patient with massive posterosuperior rotator cuff tear, Goutallier ≥2 teres minor fatty infiltration, a positive hornblower's sign, and combined pseudoparesis of both elevation and external rotation, reverse arthroplasty alone will leave the external rotation deficit unaddressed — this paper established that adding a simultaneous latissimus dorsi transfer can restore functional external rotation control in a single operative session, though measurable arc gains are modest and infection risk demands careful patient selection.
Gerber et al. report a preliminary case series evaluating simultaneous reverse total shoulder arthroplasty and latissimus dorsi transfer in patients with combined pseudoparesis of both elevation and external rotation — a population in whom reverse arthroplasty alone consistently underperforms due to absent teres minor function.
When you see a patient with massive posterosuperior rotator cuff tear, Goutallier ≥2 teres minor fatty infiltration, a positive hornblower's sign, and combined pseudoparesis of both elevation and external rotation, reverse arthroplasty alone will leave the external rotation deficit unaddressed — this paper established that adding a simultaneous latissimus dorsi transfer can restore functional external rotation control in a single operative session, though measurable arc gains are modest and infection risk demands careful patient selection.