ArticleJournal of orthopaedic case reports2026
Anterior Latissimus Dorsi and Teres Major Tendon Transfer with Total Shoulder Arthroplasty in the Setting of Subscapularis Insufficiency: A Case Report.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Anatomic total shoulder arthroplasty (TSA) is the standard treatment for glenohumeral osteoarthritis with an intact rotator cuff; however, irreparable subscapularis tears often contraindicate TSA due to compromised anterior stability. Reverse TSA (RTSA) is commonly performed in such cases but alters native biomechanics and may limit rotational strength. Case Report: A 69-year-old female presented with chronic shoulder pain and functional limitation. Imaging revealed advanced glenohumeral osteoarthritis with a full-thickness irreparable subscapularis tear, while the posterosuperior rotator cuff remained intact. The patient underwent anatomic TSA combined with anterior Latissimus dorsi and teres major (LDTM) tendon transfer and partial subscapularis repair. At 4-year follow-up, significant improvements were observed in pain and function, with Visual Analog Scale improving from 5 to 1, Constant score from 59 to 82, and American Shoulder and Elbow Surgeons score from 56 to 81. Range of motion and strength improved across all planes. Radiographs demonstrated stable implant fixation without complications, and sonography confirmed an intact tendon transfer. The patient returned to daily activities without pain and reported high satisfaction. Conclusion: Anatomic TSA combined with anterior LDTM tendon transfer may be a viable alternative to RTSA in selected patients with glenohumeral osteoarthritis and irreparable subscapularis tears.
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