1
|
Jeske HC, Tauber M, Wambacher M, Perwanger F, Liebensteiner M, Kralinger F. Clinical outcomes in latissimus dorsi transfer single- versus double-incision technique. Arch Orthop Trauma Surg 2023; 143:1741-1751. [PMID: 34994856 DOI: 10.1007/s00402-021-04291-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 11/27/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND/HYPOTHESIS In patients with irreparable postero-superior rotator cuff lesions, a latissimus dorsi transfer (LDT) is performed. For this surgery, different techniques are used. In this study, we aim to compare the patient's functional outcome after treatment with modified L'Episcopo "single-incision" and modified Gerber "double-incision" technique for LDT. METHODS 44 patients with irreparable postero-superior rotator cuff ruptures, refractory to physiotherapeutic treatment were included. 21 patients were treated using a modified L'Episcopo "single-incision", 23 patients with modified Gerber "double-incision" surgical approach. All patients had full-thickness tears of at least two complete tendons, and all had fully functioning deltoid and subscapularis muscles. Preoperatively, there were statistically significant differences between the two groups in all preoperative CMS sub-parameters except "power" and "pain". In the postoperative follow-up, a functional assessment using "Constant-Murley Score" (CMS) and "Age- and gender-related CMS" was conducted. STUDY DESIGN Retrospective-comparative trial. LEVEL OF EVIDENCE III RESULTS There were no statistically significant differences between age, sex and time of follow-up between the two study groups (p > 0.05). The mean age was 59.2(± 6.3) years, and the mean follow-up time was 45.4(± 9.3) months for both groups taken together. Mean CMS improved for both groups together from 24.2 ± 8.2 points prior to surgery, to 62.8 ± 17.4 points after a mean follow-up time of 45.4 ± 9.3 months post surgery. The patients treated with "single-incision" surgery (n = 21) gained significantly (p < 0.001) more in CMS and all CMS-sub-scoring parameters except power and pain, compared to the patients treated with "double-incision" technique (n = 23). CONCLUSION This survey shows appealing post-operative functional outcome in patients with irreparable postero-superior rotator cuff lesions treated with two different techniques for LDT. We believe that the presentation of these methods and their results might encourage shoulder surgeons to implement these techniques. Especially the "single-incision" LDT surgery might be a more accustomed technique for many shoulder surgeons well trained in the deltopectoral approach.
Collapse
Affiliation(s)
- Hans-Christian Jeske
- Department of Traumatology and Orthopedics, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
- Orthoplus, Talfergasse 2, 39100, Bolzano, Italy.
| | - Mark Tauber
- ATOS Clinic, Effnerstraße 38, 81925, Munich, Germany
- Department of Traumatology and Orthopedics, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Markus Wambacher
- Department of Traumatology and Orthopedics, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria
| | | | - Michael Liebensteiner
- Department of Traumatology and Orthopedics, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Franz Kralinger
- Department of Traumatology, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria
| |
Collapse
|
2
|
LaBelle MW, Mengers S, Strony J, Peck M, Flannery R, Cupp S, Salata MJ, Parsons EM, Gillespie RJ. Evaluating the role of graft integrity on outcomes: clinical and imaging results following superior capsular reconstruction. J Shoulder Elbow Surg 2021; 30:2041-2047. [PMID: 33545335 DOI: 10.1016/j.jse.2020.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 12/01/2020] [Accepted: 12/17/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Superior capsular reconstruction (SCR) addresses massive, irreparable rotator cuff tears in young patients. The purpose of this study was to retrospectively evaluate clinical outcomes and graft integrity in patients following SCR. METHODS Thirty-four consecutive patients undergoing SCR by 2 surgeons with minimum 2-year follow-up were identified. Functional outcomes were obtained, including Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), visual analog scale (VAS), and Single Assessment Numeric Evaluation (SANE) scores. Graft integrity was evaluated on magnetic resonance images (MRIs). RESULTS Thirty-five shoulders in 34 patients were identified. Four patients underwent subsequent surgery. The mean preoperative scores were SST 21.6 ± 17.6, ASES 28.3 ± 10.1, SANE 50.6 ± 22.1, and VAS 6.6 ± 1.7. The mean postoperative outcomes were SST 79.1 ± 19.6, ASES 79.9 ± 17.4, SANE 74.3 ± 18.7, and VAS 1.5 ± 2.2. There was statistically significant improvement in SST, ASES, and VAS following SCR. MRI revealed graft failure in 62% (n = 13 of 21) of shoulders. Radiographic evidence of graft healing did not have any effect on SST, ASES, SANE, or VAS scores. CONCLUSION Given the high rate of graft failure without a significant difference in clinical outcomes, graft healing after SCR might not be an independent predictor of success. The improved clinical improvement in patients undergoing SCR may be due to other known beneficial aspects of the procedure, including partial rotator cuff repair, débridement, and biceps management.
Collapse
Affiliation(s)
- Mark W LaBelle
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Orthopaedic Surgery, University Hospitals Sports Medicine Institute, Cleveland, OH, USA
| | - Sunita Mengers
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Orthopaedic Surgery, University Hospitals Sports Medicine Institute, Cleveland, OH, USA.
| | - John Strony
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Orthopaedic Surgery, University Hospitals Sports Medicine Institute, Cleveland, OH, USA
| | - Matthew Peck
- Case Western Reserve University Medical School, Cleveland, OH, USA
| | - Robert Flannery
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Orthopaedic Surgery, University Hospitals Sports Medicine Institute, Cleveland, OH, USA
| | - Sean Cupp
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Orthopaedic Surgery, University Hospitals Sports Medicine Institute, Cleveland, OH, USA
| | - Michael J Salata
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Orthopaedic Surgery, University Hospitals Sports Medicine Institute, Cleveland, OH, USA
| | | | - Robert J Gillespie
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Orthopaedic Surgery, University Hospitals Sports Medicine Institute, Cleveland, OH, USA
| |
Collapse
|
3
|
Silberberg JM, Nilo A, Roces-García J. Enhancement of External Rotation after Latissimus Dorsi Tendon Transfer (LDTT): A Cadaveric Study. ACTA ACUST UNITED AC 2021; 57:medicina57040305. [PMID: 33804946 PMCID: PMC8063920 DOI: 10.3390/medicina57040305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/08/2021] [Accepted: 03/21/2021] [Indexed: 11/23/2022]
Abstract
Background and objectives: Massive rotator cuff tears compromise shoulder mobility function and cannot be directly repaired. Latissimus dorsi tendon transfer (LDTT) is a therapeutic alternative suitable for the treatment of rotator cuff tears that helps to restore external shoulder rotation. Cadaver models have been used for studying the effects of LDTT and procedural variations, but, to the best of our knowledge, none of them have been validated. The aim of our study was to validate a novel cadaver model while verifying the effects of LDTT on external rotation. Materials and Methods: Two groups were included in the study: a cadaver group and a control group made up of healthy volunteers, which were used for the validation of the cadaver model. Baseline external rotation measurements were performed with both groups, after which a massive rotator cuff tear was inflicted and repaired with LDTT in the cadaver group. Their postoperative external rotation was evaluated using three different tests. Results: No statistically significant differences were found between the baseline measurements of the two groups, and postoperative external rotation was significantly higher after LDTT in all cases but one. Conclusions: Cadaver models were validated, since they had a similar preoperative external rotation to healthy volunteers. Moreover, they allowed us to demonstrate the effect of LDTT on external shoulder rotation.
Collapse
Affiliation(s)
- José M. Silberberg
- Orthopaedic Surgery and Traumatology Head Department, Sports Medicine Unit, Clínica Universidad de Navarra, 28027 Madrid, Spain
- Correspondence: ; Tel.: +34-985-182-636
| | - Alessandro Nilo
- Orthopaedic Surgery and Traumatology Department, Chief of Upper Limb Unit, Hospital General Regional N1, 97155 Mérida, Mexico;
| | - Jorge Roces-García
- Department of Construction and Manufacturing Engineering, Polytechnic School of Engineering of Gijón, University of Oviedo, Pedro Puig Adam s/n, ED06, 33203 Gijón, Spain;
| |
Collapse
|
4
|
Gates S, Sager B, Collett G, Chhabra A, Khazzam M. Surgically relevant anatomy of the axillary and radial nerves in relation to the latissimus dorsi tendon in variable shoulder positions: A cadaveric study. Shoulder Elbow 2020; 12:24-30. [PMID: 32010230 PMCID: PMC6974889 DOI: 10.1177/1758573218825476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/29/2018] [Accepted: 12/08/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND The purpose of this study was to define the relationship of the axillary and radial nerves, particularly how these are affected with changing arm position. METHODS Twenty cadaveric shoulders were dissected, identifying the axillary and radial nerves. Distances between the latissimus dorsi tendon and these nerves were recorded in different shoulder positions. Positions included adduction/neutral rotation, abduction/neutral rotation for the axillary nerve, adduction/internal rotation, adduction/neutral rotation, adduction/external rotation, and abduction/external rotation for the radial nerve. RESULTS Width of the latissimus tendon at its humeral insertion was 29.3 ± 5.7 mm. Mean distance from the latissimus insertion to the axillary nerve in adduction/neutral rotation was 24.2 ± 7.1 mm, the distance increased to 41.1 ± 9.8 mm in abduction/neutral rotation. Mean distance from the latissimus insertion to the radial nerve was 15.3 ± 5.5 mm with adduction/internal rotation, 25.8 ± 6.9 mm in adduction/neutral rotation, and 39.5 ± 6.8 mm in adduction/external rotation. Mean distance increased with abduction/external rotated 51.1 ± 7.4 mm. CONCLUSIONS Knowing the axillary and radial nerve locations relative to the latissimus dorsi tendon decreases the risk of iatrogenic nerve injury. Understanding the dynamic nature of these nerves related to different shoulder positions is critical to avoid complications.
Collapse
Affiliation(s)
- Stephen Gates
- Shoulder Service, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Brian Sager
- Shoulder Service, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Garen Collett
- Shoulder Service, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Avneesh Chhabra
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Michael Khazzam
- Shoulder Service, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
5
|
Moursy M, Schmalzl J, Kadavkolan AS, Bartels N, Lehmann LJ. Latissimus dorsi transfer for massive posterosuperior rotator cuff tears: what affects the postoperative outcome? J Shoulder Elbow Surg 2019; 28:2191-2197. [PMID: 31262636 DOI: 10.1016/j.jse.2019.03.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/27/2019] [Accepted: 03/07/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND The management of irreparable posterosuperior rotator cuff tears (IPSRCTs) in young active individuals is still a challenge. The aim of this study was to evaluate the influence of sex, surgical technique, previous surgical procedures, tear genesis, and presence of a preoperative external rotation lag sign on the functional outcome after latissimus dorsi transfer (LDT) for IPSRCTs. METHODS Retrospectively, all patients with IPSRCTs treated with LDT during a 10-year period were followed up. Preoperative evaluation included the visual analog scale (VAS) score, range of motion, and the Constant score (CS). Postoperatively, the VAS score, range of motion, CS, American Shoulder and Elbow Surgeons score, and Subjective Shoulder Value were recorded. Preoperative and postoperative radiologic evaluation was performed using the Hamada-Fukuda classification and the acromiohumeral interval. RESULTS In total, 67 of 79 patients (85%), with a mean age of 63 years, were available for follow-up at 54 ± 28 months. The CS improved from 24 ± 6 points preoperatively to 68 ± 17 points at follow-up (P < .001). Active flexion increased from 83° ± 47° to 144° ± 35°; abduction, from 69° ± 33° to 134° ± 42°; and external rotation, from 24° ± 18° to 35° ± 21°. Postoperatively, the Subjective Shoulder Value was 69% ± 19% and the American Shoulder and Elbow Surgeons score was 76 ± 21. The VAS score decreased from 6.3 ± 1.1 to 1.8 ± 2 (P < .001). Abduction strength increased from 0.4 ± 0.4 kg to 3.6 ± 2.2 kg (P < .001). The acromiohumeral interval decreased from 7.9 ± 2.6 mm to 5.1 ± 2.2 mm, and arthropathy worsened from Hamada-Fukuda stage 1.4 to stage 2.1. The rate of conversion to a reverse prosthesis was 6%. CONCLUSION LDT represents a reliable and reproducible treatment option with good clinical midterm results after surgical treatment. Sex, genesis, preoperative presence of an external rotation lag sign, and previous surgical procedures do not affect the overall clinical outcome.
Collapse
Affiliation(s)
- Mohamed Moursy
- Orthopaedic and Trauma Surgery Centre (OUZ), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Traumatology and Orthopaedic Surgery, University Hospital Salzburg, Salzburg, Austria.
| | - Jonas Schmalzl
- Department of Traumatology and Hand Surgery, St. Vincentius Clinic, Teaching Hospital Albert-Ludwigs-University Freiburg, Karlsruhe, Germany
| | - Aditya S Kadavkolan
- Orthopaedic and Trauma Surgery Centre (OUZ), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Dr. LH Hiranandani Hospital, Mumbai, India
| | - Niko Bartels
- Orthopaedic and Trauma Surgery Centre (OUZ), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lars-Johannes Lehmann
- Orthopaedic and Trauma Surgery Centre (OUZ), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Traumatology and Hand Surgery, St. Vincentius Clinic, Teaching Hospital Albert-Ludwigs-University Freiburg, Karlsruhe, Germany
| |
Collapse
|
6
|
Lewington MR, Ferguson DP, Smith TD, Burks R, Coady C, Wong IHB. Graft Utilization in the Bridging Reconstruction of Irreparable Rotator Cuff Tears: A Systematic Review. Am J Sports Med 2017; 45:3149-3157. [PMID: 28345960 DOI: 10.1177/0363546517694355] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Rotator cuff tears are one of the most common conditions affecting the shoulder. Because of the difficulty in managing massive rotator cuff tears and the inability of standard techniques to prevent arthropathy, surgeons have developed several novel techniques to improve outcomes and ideally alter the natural history. PURPOSE To systematically review the existing literature and analyze reported outcomes to evaluate the effectiveness of using a bridging graft reconstruction technique to treat large to massive irreparable rotator cuff tears. STUDY DESIGN Systematic review. METHODS A systematic search of PubMed, EMBASE, CINAHL, and CENTRAL was employed with the key terms "tear," "allograft," and "rotator cuff." Eligibility was determined by a 3-phase screening process according to the outlined inclusion/exclusion criteria. Data in relation to the primary and secondary outcomes were summarized. The results were synthesized according to the origin of the graft and the level of evidence. RESULTS Fifteen studies in total were included in this review: 2 comparative studies and 13 observational case series. Both the biceps tendon and the fascia lata autograft groups had significantly superior structural integrity rates on magnetic resonance imaging at 12-month minimum follow-up when compared with their partial primary repair counterparts (58% vs 26%, P = .036; 79% vs 58%, P < .05), respectively. Multiple noncomparative case series investigating allografts, xenografts, and synthetic materials for bridging reconstruction of large to massive rotator cuff tears demonstrated high structural healing rates (74%-90%, 73%-100%, and 60%-90%, respectively). Additionally, both comparative studies and case series demonstrated a general improvement of patients' functional outcome scores. CONCLUSION Using a graft for an anatomic bridging rotator cuff repair results in improved function on objective testing and may be functionally better than nonanatomic or partial repair of large to massive rotator cuff tears. Allograft or xenograft techniques appear to be favorable options, given demonstrated functional improvement, imaging-supported graft survival, and lack of harvest complication risk. More high-quality randomized controlled studies are needed to further assess this technique.
Collapse
Affiliation(s)
- Matthew R Lewington
- Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Devin P Ferguson
- Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - T Duncan Smith
- Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Robert Burks
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
| | - Catherine Coady
- Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ivan Ho-Bun Wong
- Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
7
|
Latissimus-dorsi-Transfer. ARTHROSKOPIE 2017. [DOI: 10.1007/s00142-017-0141-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
8
|
Anastasopoulos PP, Alexiadis G, Spyridonos S, Fandridis E. Latissimus Dorsi Transfer in Posterior Irreparable Rotator Cuff Tears. Open Orthop J 2017; 11:77-94. [PMID: 28400877 PMCID: PMC5366394 DOI: 10.2174/1874325001711010077] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 04/09/2016] [Accepted: 04/20/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Massive rotator cuff tears pose a difficult and complex challenge even for the experienced surgeon; inability to repair these tears by conventional means designates them as irreparable, while management becomes quite taxing. Several operative options have been suggested for the management of such lesions with varying degrees of success, while it is imperative to match patient demands and expectations to the predicted outcome. METHODS Research articles are examined and key concepts are discussed, in order to provide an evidence based review of the available literature. The anatomy and pathomechanics along with the indications, contraindications and surgical techniques are reported. RESULTS Transfer of the Latissimus dorsi has been used with success to restore shoulder function in deficits of the posterior rotator cuff. Although it can be used in a variety of settings, the ideal patient for a Latissimus dorsi tendon transfer is a young and active individual, with no glenohumeral osteoarthritis that has a severe disability and weakness related to an irreparable posterior cuff tear. CONCLUSION Tendon transfers have proved to be a successful treatment option in salvaging this difficult problem, providing pain relief and restoring shoulder function. Despite the excellent functional outcomes and pain suppression following operation, a variety of factors may affect the outcome; thus making indications and preoperative assessment a valuable component.
Collapse
Affiliation(s)
- Panagiotis P Anastasopoulos
- Hand Surgery-Upper Limb and Microsurgery Department, KAT General Hospital, Nikis 2 Str, Kifisia 145-61, Athens, Greece
| | - George Alexiadis
- Hand Surgery-Upper Limb and Microsurgery Department, KAT General Hospital, Nikis 2 Str, Kifisia 145-61, Athens, Greece
| | - Sarantis Spyridonos
- Hand Surgery-Upper Limb and Microsurgery Department, KAT General Hospital, Nikis 2 Str, Kifisia 145-61, Athens, Greece
| | - Emmanouil Fandridis
- Hand Surgery-Upper Limb and Microsurgery Department, KAT General Hospital, Nikis 2 Str, Kifisia 145-61, Athens, Greece
| |
Collapse
|
9
|
Latissimus Dorsi Tendon Transfer with GraftJacket® Augmentation to Increase Tendon Length for an Irreparable Rotator Cuff Tear. Case Rep Orthop 2017; 2017:8086065. [PMID: 28194290 PMCID: PMC5282417 DOI: 10.1155/2017/8086065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/20/2016] [Accepted: 12/25/2016] [Indexed: 11/18/2022] Open
Abstract
Massive irreparable rotator cuff tears can be reconstructed with latissimus dorsi tendon transfers (LDTT). Although uncommon, the natural length of the latissimus dorsi tendon (LDT) could be insufficient for transfer even after adequate soft tissue releases. Descriptions of cases where grafts were needed to lengthen the LDT are therefore rare. We located only two reports of the use of an acellular dermal matrix to increase effective tendon length in tendon transfers about the shoulder: (1) GraftJacket patch for a pectoralis major tendon reconstruction and (2) ArthroFlex® patch for LDTT. Both of these brands of allograft patches are obtained from human cadavers. These products are usually used to cover soft tissue repairs and offer supplemental support rather than for increasing tendon length. Extending the LDTT with GraftJacket to achieve adequate length, to our knowledge, has not been reported in the literature. We report the case of a 50-year-old male who had a massive, irreparable left shoulder rotator cuff tear that was reconstructed with a LDTT. The natural length of his LDT was insufficient for transfer. This unexpected situation was rectified by sewing two patches of GraftJacket to the LDT. The patient had greatly improved shoulder function at two-year follow-up.
Collapse
|
10
|
Boutin RD, Fritz RC. MRI of Musculotendinous Injuries—What’s New? Part II: Strain Injuries. CURRENT RADIOLOGY REPORTS 2015. [DOI: 10.1007/s40134-015-0109-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
11
|
Grimberg J, Kany J. Latissimus dorsi tendon transfer for irreparable postero-superior cuff tears: current concepts, indications, and recent advances. Curr Rev Musculoskelet Med 2014; 7:22-32. [PMID: 24458942 DOI: 10.1007/s12178-013-9196-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Latissimus dorsi tendon transfer is a method for surgical treatment of massive irreparable posterosuperior cuff tears. It partially restores active anteflexion, external rotation, and function of the shoulder but does not significantly increase strength of the shoulder. It is contraindicated in case of pseudoparalytic shoulder; associated irreparable subscapularis tear, deltoid palsy, and in case of associated osteoarthritis, as an isolated procedure. Results are inferior when performed as a secondary procedure compared with a primary procedure. However, latissimus dorsi tendon transfer is an attractive solution to improve shoulder mobility and function of young and non osteoarthritic patients whose previous surgical treatment of massive postero-superior irreparable rotator cuff tear failed. As a primary procedure, latissimus dorsi tendon transfer competes with debridement, biceps tenotomy, and partial cuff repair. In association with reverse shoulder arthroplasty, it restores active external rotation in osteoarthritic patients with active external rotation deficit. New arthroscopic assisted techniques might improve results in the future.
Collapse
Affiliation(s)
- Jean Grimberg
- IRCOS (Institut de Recherche en Chirurgie Osseuse et Sportive), 6 avenue Alphonse XIII, 75016, Paris, France,
| | | |
Collapse
|
12
|
Indikation, Technik und Ergebnisse von Sehnentransferoperationen. ARTHROSKOPIE 2014. [DOI: 10.1007/s00142-013-0770-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
13
|
Ross A, Birch R. Response to: Ghosh S, Singh VK, Jeyaseelan L,Sinisi M, Fox M. Isolated latissimus dorsi transfer to restore shoulder external rotation in adults with brachial plexus injury. Bone Joint J 2013;95-B:660–663. Bone Joint J 2013; 95-B:1150. [PMID: 23908436 DOI: 10.1302/0301-620x.95b8.32748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We welcome letters to the Editor concerning articles that have recently been published. Such letters will be subject to the usual stages of selection and editing; where appropriate the authors of the original article will be offered the opportunity to reply.
Collapse
|