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Functional status and failed rotator cuff repair predict outcomes after arthroscopic-assisted latissimus dorsi transfer for irreparable massive rotator cuff tears.
J Shoulder Elbow Surg 2016; 25(4):658-65JS

Abstract

BACKGROUND

Arthroscopic-assisted latissimus dorsi tendon transfer (LDTT) has been recently introduced for treatment of irreparable, posterosuperior massive rotator cuff tears. We sought to evaluate the functional outcomes of this technique and to check for possible outcome predictors.

METHODS

The study reviewed 86 patients (aged 59.8 ± 5.9 years) who underwent an arthroscopic-assisted latissimus dorsi tendon transfer after 36.4 ± 9 months of follow-up. Of these, 14 patients (16.3%) sustained an irreparable massive rotator cuff tear after a failed arthroscopic rotator cuff repair. The Constant and Murley score (CMS) was used to assess patients' functionality preoperatively and at follow-up.

RESULTS

As a group, the CMS improved with surgery from 35.5 ± 6.1 to 69.5 ± 12.3 (P < .001). A lower preoperative CMS and a previous failed rotator cuff repair resulted in lower postoperative range of motion (P = .044 and P = .007, respectively) and CMS (P = .042 and P = .018, respectively). A previous rotator cuff repair resulted in lower satisfaction with surgery (P = .009). Gender and age did not affect the clinical outcomes.

CONCLUSIONS

Our results support the effectiveness of arthroscopic-assisted LDTT in the treatment of patients with an irreparable, posterosuperior massive rotator cuff tears in pain relief, functional recovery, and postoperative satisfaction. Patients with lower preoperative CMS and a history of failed rotator cuff repair have a greater likelihood of having a lower clinical result. However, the favorable values of summary postoperative scores do not exclude these patients as candidates for arthroscopic-assisted LDTT.

Authors+Show Affiliations

Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, Catanzaro, Italy.Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, Catanzaro, Italy.Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, Catanzaro, Italy.Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, Catanzaro, Italy. Electronic address: gasparini@unicz.it.Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, Catanzaro, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26589917

Citation

Castricini, Roberto, et al. "Functional Status and Failed Rotator Cuff Repair Predict Outcomes After Arthroscopic-assisted Latissimus Dorsi Transfer for Irreparable Massive Rotator Cuff Tears." Journal of Shoulder and Elbow Surgery, vol. 25, no. 4, 2016, pp. 658-65.
Castricini R, De Benedetto M, Familiari F, et al. Functional status and failed rotator cuff repair predict outcomes after arthroscopic-assisted latissimus dorsi transfer for irreparable massive rotator cuff tears. J Shoulder Elbow Surg. 2016;25(4):658-65.
Castricini, R., De Benedetto, M., Familiari, F., De Gori, M., De Nardo, P., Orlando, N., ... Galasso, O. (2016). Functional status and failed rotator cuff repair predict outcomes after arthroscopic-assisted latissimus dorsi transfer for irreparable massive rotator cuff tears. Journal of Shoulder and Elbow Surgery, 25(4), pp. 658-65. doi:10.1016/j.jse.2015.08.043.
Castricini R, et al. Functional Status and Failed Rotator Cuff Repair Predict Outcomes After Arthroscopic-assisted Latissimus Dorsi Transfer for Irreparable Massive Rotator Cuff Tears. J Shoulder Elbow Surg. 2016;25(4):658-65. PubMed PMID: 26589917.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional status and failed rotator cuff repair predict outcomes after arthroscopic-assisted latissimus dorsi transfer for irreparable massive rotator cuff tears. AU - Castricini,Roberto, AU - De Benedetto,Massimo, AU - Familiari,Filippo, AU - De Gori,Marco, AU - De Nardo,Pasquale, AU - Orlando,Nicola, AU - Gasparini,Giorgio, AU - Galasso,Olimpio, Y1 - 2015/11/14/ PY - 2015/06/12/received PY - 2015/08/24/revised PY - 2015/08/25/accepted PY - 2015/11/22/entrez PY - 2015/11/22/pubmed PY - 2016/9/28/medline KW - Arthroscopic-assisted latissimus dorsi transfer KW - Constant and Murley score KW - failed rotator cuff repair KW - irreparable massive rotator cuff tears KW - outcome predictors SP - 658 EP - 65 JF - Journal of shoulder and elbow surgery JO - J Shoulder Elbow Surg VL - 25 IS - 4 N2 - BACKGROUND: Arthroscopic-assisted latissimus dorsi tendon transfer (LDTT) has been recently introduced for treatment of irreparable, posterosuperior massive rotator cuff tears. We sought to evaluate the functional outcomes of this technique and to check for possible outcome predictors. METHODS: The study reviewed 86 patients (aged 59.8 ± 5.9 years) who underwent an arthroscopic-assisted latissimus dorsi tendon transfer after 36.4 ± 9 months of follow-up. Of these, 14 patients (16.3%) sustained an irreparable massive rotator cuff tear after a failed arthroscopic rotator cuff repair. The Constant and Murley score (CMS) was used to assess patients' functionality preoperatively and at follow-up. RESULTS: As a group, the CMS improved with surgery from 35.5 ± 6.1 to 69.5 ± 12.3 (P < .001). A lower preoperative CMS and a previous failed rotator cuff repair resulted in lower postoperative range of motion (P = .044 and P = .007, respectively) and CMS (P = .042 and P = .018, respectively). A previous rotator cuff repair resulted in lower satisfaction with surgery (P = .009). Gender and age did not affect the clinical outcomes. CONCLUSIONS: Our results support the effectiveness of arthroscopic-assisted LDTT in the treatment of patients with an irreparable, posterosuperior massive rotator cuff tears in pain relief, functional recovery, and postoperative satisfaction. Patients with lower preoperative CMS and a history of failed rotator cuff repair have a greater likelihood of having a lower clinical result. However, the favorable values of summary postoperative scores do not exclude these patients as candidates for arthroscopic-assisted LDTT. SN - 1532-6500 UR - https://www.unboundmedicine.com/medline/citation/26589917/Functional_status_and_failed_rotator_cuff_repair_predict_outcomes_after_arthroscopic_assisted_latissimus_dorsi_transfer_for_irreparable_massive_rotator_cuff_tears_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1058-2746(15)00480-2 DB - PRIME DP - Unbound Medicine ER -