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Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears: Short-Term Results.
J Bone Joint Surg Am 2014; 96(14):e119JB

Abstract

BACKGROUND

Irreparable rotator cuff tears associated with shoulder functional impairment represent a challenge, especially in young and active patients. Latissimus dorsi muscle-tendon transfer is performed to replace the irreversibly lost contractile elements in patients with irreparable tears of the posterosuperior aspect of the rotator cuff.

METHODS

From 2008 to 2010, we enrolled twenty-seven patients (mean age, sixty years; range, forty-six to sixty-seven years) with irreparable, full-thickness rotator cuff tears involving at least two tendons who underwent arthroscopic-assisted latissimus dorsi muscle-tendon transfer. Outcome measures included the Constant and Murley score, shoulder range of motion in external rotation, and muscle strength in forward elevation. The mean duration of follow-up was twenty-seven months (range, twenty-four to thirty-six months).

RESULTS

There was a significant improvement (p < 0.05) in the mean Constant and Murley score, pain score, muscle strength in forward elevation, and range of motion in external rotation at the time of the last follow-up. There was no significant correlation between the mean preoperative range of motion, pain, and strength and the mean postoperative Constant and Murley score. There was no significant osteoarthritis progression and proximal migration of the humeral head after surgery in the time period studied.

CONCLUSIONS

Arthroscopic-assisted latissimus dorsi muscle-tendon transfer at short-term follow-up is an effective alternative to open surgery for the management of painful irreparable posterosuperior rotator cuff tears refractory to conservative management.

LEVEL OF EVIDENCE

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Authors+Show Affiliations

Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Via Corriera 1, 48010 Cotignola, Ravenna, Italy. E-mail address for R. Zini: raulzini@libero.it.Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy. E-mail address for U.G. Longo: g.longo@unicampus.it. E-mail address for M. Loppini: m.loppini@unicampus.it. E-mail address for V. Denaro: v.denaro@unicampus.it.Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Via Corriera 1, 48010 Cotignola, Ravenna, Italy. E-mail address for R. Zini: raulzini@libero.it.Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy. E-mail address for U.G. Longo: g.longo@unicampus.it. E-mail address for M. Loppini: m.loppini@unicampus.it. E-mail address for V. Denaro: v.denaro@unicampus.it.Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Via Corriera 1, 48010 Cotignola, Ravenna, Italy. E-mail address for R. Zini: raulzini@libero.it.Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England. E-mail address: n.maffulli@qmul.ac.uk.Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy. E-mail address for U.G. Longo: g.longo@unicampus.it. E-mail address for M. Loppini: m.loppini@unicampus.it. E-mail address for V. Denaro: v.denaro@unicampus.it.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25031381

Citation

Castricini, Roberto, et al. "Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears: Short-Term Results." The Journal of Bone and Joint Surgery. American Volume, vol. 96, no. 14, 2014, pp. e119.
Castricini R, Longo UG, De Benedetto M, et al. Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears: Short-Term Results. J Bone Joint Surg Am. 2014;96(14):e119.
Castricini, R., Longo, U. G., De Benedetto, M., Loppini, M., Zini, R., Maffulli, N., & Denaro, V. (2014). Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears: Short-Term Results. The Journal of Bone and Joint Surgery. American Volume, 96(14), pp. e119.
Castricini R, et al. Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears: Short-Term Results. J Bone Joint Surg Am. 2014 Jul 16;96(14):e119. PubMed PMID: 25031381.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears: Short-Term Results. AU - Castricini,Roberto, AU - Longo,Umile Giuseppe, AU - De Benedetto,Massimo, AU - Loppini,Mattia, AU - Zini,Raul, AU - Maffulli,Nicola, AU - Denaro,Vincenzo, PY - 2014/7/18/pubmed PY - 2014/7/18/medline PY - 2014/7/18/entrez SP - e119 EP - e119 JF - The Journal of bone and joint surgery. American volume JO - J Bone Joint Surg Am VL - 96 IS - 14 N2 - BACKGROUND: Irreparable rotator cuff tears associated with shoulder functional impairment represent a challenge, especially in young and active patients. Latissimus dorsi muscle-tendon transfer is performed to replace the irreversibly lost contractile elements in patients with irreparable tears of the posterosuperior aspect of the rotator cuff. METHODS: From 2008 to 2010, we enrolled twenty-seven patients (mean age, sixty years; range, forty-six to sixty-seven years) with irreparable, full-thickness rotator cuff tears involving at least two tendons who underwent arthroscopic-assisted latissimus dorsi muscle-tendon transfer. Outcome measures included the Constant and Murley score, shoulder range of motion in external rotation, and muscle strength in forward elevation. The mean duration of follow-up was twenty-seven months (range, twenty-four to thirty-six months). RESULTS: There was a significant improvement (p < 0.05) in the mean Constant and Murley score, pain score, muscle strength in forward elevation, and range of motion in external rotation at the time of the last follow-up. There was no significant correlation between the mean preoperative range of motion, pain, and strength and the mean postoperative Constant and Murley score. There was no significant osteoarthritis progression and proximal migration of the humeral head after surgery in the time period studied. CONCLUSIONS: Arthroscopic-assisted latissimus dorsi muscle-tendon transfer at short-term follow-up is an effective alternative to open surgery for the management of painful irreparable posterosuperior rotator cuff tears refractory to conservative management. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. SN - 1535-1386 UR - https://www.unboundmedicine.com/medline/citation/25031381/Arthroscopic_Assisted_Latissimus_Dorsi_Transfer_for_the_Management_of_Irreparable_Rotator_Cuff_Tears:_Short_Term_Results_ L2 - http://dx.doi.org/10.2106/JBJS.L.01091 DB - PRIME DP - Unbound Medicine ER -