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Arthroscopic-assisted latissimus dorsi tendon transfer for irreparable posterosuperior cuff tears.
Arthroscopy 2015; 31(4):599-607.e1A

Abstract

PURPOSE

To evaluate, in a multicenter, prospective study, the clinical, magnetic resonance imaging (MRI), and radiologic results of arthroscopic-assisted latissimus dorsi (LD) tendon transfer for irreparable posterosuperior rotator cuff tears; and to assess the influence of perioperative data on clinical results.

METHODS

Fifty-five patients with irreparable tears of at least the supraspinatus and infraspinatus tendons were managed with arthroscopic-assisted LD tendon transfer and reviewed clinically, with standardized radiographs and MRI, after a mean of 29 months. Outcome measures included the Constant score and the Subjective Shoulder Value. The osteoarthritic stage and acromiohumeral distance were measured on standardized radiographs, and the transferred tendon aspect was evaluated on MRI.

RESULTS

Thirty patients had already undergone 1 or more previous surgical procedures. The mean Subjective Shoulder Value increased from 26% preoperatively to 71% postoperatively. The Constant score improved from 37 preoperatively to 65.4 postoperatively. The pain score increased from 1.7 preoperatively to 12.6 postoperatively; the activity score, from 6.4 to 13.8; active forward flexion, from 134° to 157°; active abduction, from 67° to 92.5°; active external rotation, from 29° to 41.5°; and abduction strength, from 1.4 kg to 4.8 kg. The only statistically significant factor negatively influencing the Constant score was previous surgery. Four patients had a ruptured LD tendon on MRI follow-up at 1 year. There was no statistical difference between preoperative and final follow-up acromiohumeral distance. There was no increase in osteoarthritic stage.

CONCLUSIONS

Arthroscopic-assisted LD tendon transfer improves shoulder pain and function in patients with irreparable posterosuperior cuff tears, with similar clinical and radiologic results compared with results of published series using open techniques. Patients with a history of surgery had lower Constant scores compared with non-previously operated patients.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

Authors+Show Affiliations

L'Institut de Recherché en Chirurgie Orthopédique et Sportive, Paris, France. Electronic address: j.grimberg@lircos.org.Clinique de l'Union, Saint Jean, France.Clinique Jouvenet, Paris, France.St John's Medical College and Hospital, Bangalore, India.Sarvajanik College of Physiotherapy, Surat, India.

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

25498458

Citation

Grimberg, Jean, et al. "Arthroscopic-assisted Latissimus Dorsi Tendon Transfer for Irreparable Posterosuperior Cuff Tears." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 31, no. 4, 2015, pp. 599-607.e1.
Grimberg J, Kany J, Valenti P, et al. Arthroscopic-assisted latissimus dorsi tendon transfer for irreparable posterosuperior cuff tears. Arthroscopy. 2015;31(4):599-607.e1.
Grimberg, J., Kany, J., Valenti, P., Amaravathi, R., & Ramalingam, A. T. (2015). Arthroscopic-assisted latissimus dorsi tendon transfer for irreparable posterosuperior cuff tears. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 31(4), pp. 599-607.e1. doi:10.1016/j.arthro.2014.10.005.
Grimberg J, et al. Arthroscopic-assisted Latissimus Dorsi Tendon Transfer for Irreparable Posterosuperior Cuff Tears. Arthroscopy. 2015;31(4):599-607.e1. PubMed PMID: 25498458.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthroscopic-assisted latissimus dorsi tendon transfer for irreparable posterosuperior cuff tears. AU - Grimberg,Jean, AU - Kany,Jean, AU - Valenti,Philippe, AU - Amaravathi,Rajkumar, AU - Ramalingam,Alagappan Thangamani, Y1 - 2014/12/10/ PY - 2014/01/08/received PY - 2014/09/30/revised PY - 2014/10/03/accepted PY - 2014/12/16/entrez PY - 2014/12/17/pubmed PY - 2015/11/18/medline SP - 599 EP - 607.e1 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 31 IS - 4 N2 - PURPOSE: To evaluate, in a multicenter, prospective study, the clinical, magnetic resonance imaging (MRI), and radiologic results of arthroscopic-assisted latissimus dorsi (LD) tendon transfer for irreparable posterosuperior rotator cuff tears; and to assess the influence of perioperative data on clinical results. METHODS: Fifty-five patients with irreparable tears of at least the supraspinatus and infraspinatus tendons were managed with arthroscopic-assisted LD tendon transfer and reviewed clinically, with standardized radiographs and MRI, after a mean of 29 months. Outcome measures included the Constant score and the Subjective Shoulder Value. The osteoarthritic stage and acromiohumeral distance were measured on standardized radiographs, and the transferred tendon aspect was evaluated on MRI. RESULTS: Thirty patients had already undergone 1 or more previous surgical procedures. The mean Subjective Shoulder Value increased from 26% preoperatively to 71% postoperatively. The Constant score improved from 37 preoperatively to 65.4 postoperatively. The pain score increased from 1.7 preoperatively to 12.6 postoperatively; the activity score, from 6.4 to 13.8; active forward flexion, from 134° to 157°; active abduction, from 67° to 92.5°; active external rotation, from 29° to 41.5°; and abduction strength, from 1.4 kg to 4.8 kg. The only statistically significant factor negatively influencing the Constant score was previous surgery. Four patients had a ruptured LD tendon on MRI follow-up at 1 year. There was no statistical difference between preoperative and final follow-up acromiohumeral distance. There was no increase in osteoarthritic stage. CONCLUSIONS: Arthroscopic-assisted LD tendon transfer improves shoulder pain and function in patients with irreparable posterosuperior cuff tears, with similar clinical and radiologic results compared with results of published series using open techniques. Patients with a history of surgery had lower Constant scores compared with non-previously operated patients. LEVEL OF EVIDENCE: Level IV, therapeutic case series. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/25498458/Arthroscopic_assisted_latissimus_dorsi_tendon_transfer_for_irreparable_posterosuperior_cuff_tears_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(14)00839-1 DB - PRIME DP - Unbound Medicine ER -