Conjoint tendon lengthening for recalcitrant anterior shoulder pain after reverse shoulder arthroplasty: a technique article

The incidence of reverse shoulder arthroplasty (RSA) has increased since the Food and Drug Administration approved its use in the United States in 2004. With the current RSA implants available for surgeon use within the United States of America, each design, regardless of humeral inlay vs. onlay, distalizes the shoulder’s center of rotation. This new center of rotation purposely increases tension to the deltoid, which is the main working muscle in RSA, but also retensions the adjacent tendons. Some patients after RSA experience continued anterior shoulder discomfort that limits their active range of motion and overall patient satisfaction. It has been isolated with physical examination that there is tenderness to palpation at the coracoid process and throughout the conjoint tendon. We have completed conjoint tendon lengthening procedures on this subset of patients with excellent clinical results. This article describes the technique for patients who underwent conjoint tendon lengthening after RSA for recalcitrant anterior shoulder pain.