Letter to the Editor regarding Young et al: “Reverse shoulder arthroplasty with and without latissimus and teres major transfer for patients with combined loss of elevation and external rotation: a prospective, randomized investigation”

We read with great interest the article entitled “Reverse shoulder arthroplasty with and without latissimus and teres major transfer for patients with combined loss of elevation and external rotation: a prospective, randomized investigation” by Young et al. 22 Young B.L. Connor P.M. Schiffern S.C. Roberts K.M. Hamid N. Reverse shoulder arthroplasty with and without latissimus and teres major transfer for patients with combined loss of elevation and external rotation: a prospective, randomized investigation. J Shoulder Elbow Surg. 2020; 29: 874-881https://doi.org/10.1016/j.jse.2019.12.024 Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar We would like to commend the authors for their investigation of an important research question: Do “CLEER” patients (combined loss of elevation and external rotation) who undergo reverse shoulder arthroplasty (RSA) with latissimus dorsi and teres major transfer (+LD/TM) have better functional results than those treated with RSA alone? They performed a randomized controlled trial (RCT) and found no significant differences at 2 to 3.5 years of follow-up. At least 3 important methodological weaknesses limit the strength of this RCT and deserve discussion: patient selection, statistics, and interpretation of results. Reverse shoulder arthroplasty with and without latissimus and teres major transfer for patients with combined loss of elevation and external rotation: a prospective, randomized investigationJournal of Shoulder and Elbow SurgeryVol. 29Issue 5PreviewLatissimus dorsi (LD) and teres major (TM) tendon transfers have been performed concurrently with reverse shoulder arthroplasty (RSA) to address combined loss of elevation and external rotation (CLEER) at the shoulder. The purpose of this prospective, randomized study was to compare RSA with and without LD-TM tendon transfer in patients with rotator cuff tear arthropathy and CLEER. Full-Text PDF Response to Letter to the Editor regarding: “Reverse shoulder arthroplasty with and without latissimus and teres major transfer for patients with combined loss of elevation and external rotation: a prospective, randomized investigation”Journal of Shoulder and Elbow SurgeryVol. 30Issue 4PreviewThank you very much for your interest in our article.6 Although this study represents the highest level of evidence on this topic, we fully acknowledge that it is not without limitations. We would like to offer some considerations in response to the previous commentary. Full-Text PDF