Dear CSS Members:
In case you missed it enclosed are two interesting videos featured on vumedi. You will be prompted to sign in and if you are not a member you can join for free.
The first video by Prof. Pascal Boileau demonstrates the technique of Latissimus Dorsi Transfer with Reverse Prosthesis. This is a method he developed and the one I use and it is indicated when patients have profound external rotation loss with an evident “ER Lag sign” or “Drop arm sign”. Some surgeons are of the opinion that lateralization of the glenoid sphere will improve ER, but I do not think this is the case as I’ve seen exactly that patient with a functional loss of ER and have had to do a Lat Dorsi transfer in that setting to restore ER.
The second video by Dr. Howard Routman is an excellent overview of convertible stems and the concept of convertability. He makes the point that conversion reduces morbidity due to stem retention and, indeed, this has been shown in a number of articles including ones by Gerber and by Higgins. However, with the development of stemless primary TSA, I would suggest that the evolution of revision surgery will be removal of a stemless implant and conversion to a stem, or simply conversion of the stemless implant. This potentially offers a better value to the patient, the hospital and the surgeon, in terms of complexity and the actual final solution.
JP Warner, MD
"Latissimus Dorsi Transfer Combined with Bio-RSA" by Dr. Pascal Boileau, Nice Shoulder Institute, Nice, France.
Click here to view: Latissimus Dorsi Transfer Combined with Bio-RSA
"Revision to Reverse Shoulder Arthroplasty: The Benefits of Using a Platform System" by Dr. Howard Routman, Palm Beach Shoulder Service, Palm Beach, FL.
Click here to view: Revision to Reverse Shoulder Arthroplasty: The Benefits of Using a Platform System