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Recovery of active external rotation and elevation in young active men with irreparable posterosuperior rotator cuff tear using arthroscopically assisted latissimus dorsi transfer.
J Shoulder Elbow Surg 2016; 25(9):e265-75JS

Abstract

BACKGROUND

Massive irreparable posterosuperior rotator cuff tears represent a serious functional disablement for young and active patients in their daily activities. Latissimus dorsi (LD) muscle-tendon transfer can restore elevation and external rotation where supraspinatus and infraspinatus function is lost.

MATERIALS AND METHODS

Between 2009 and 2013, 45 consecutive patients underwent arthroscopically assisted LD transfer for an irreparable posterosuperior rotator cuff tear. Thirty-three patients agreed to participate in this retrospective study. For 8 patients, we used a standard passage of the LD through the plane between the infraspinatus-teres minor and the deltoid muscles. For the remaining 25 patients, we transferred the LD tendon in front of the triceps muscle according to a personal described technique. The follow-up period was 35.7 months. Final follow-up included assessment by standard radiographs, bipolar surface electromyography, pain score by visual analog scale, Constant-Murley shoulder score, and Disabilities of the Arm, Shoulder, and Hand score. For quantitative strength evaluation measurements, a Biodex dynamometer was used.

RESULTS

Overall clinical outcomes improved at the final follow-up and were significantly age related. We found similar results for revision and primary patients with mean increase in Constant-Murley scores of 29.5 and 30.5 points, respectively. In our series, we recorded osteoarthritis progression in 33.3% of patients.

CONCLUSION

Arthroscopic LD tendon transfer for irreparable posterosuperior rotator cuff tears can achieve good clinical outcomes at a midterm follow-up, especially in active men 60 years of age or younger and in patients with low preoperative elevation (<80°) but an intact or reparable subscapularis tendon.

Authors+Show Affiliations

Department of Orthopedics, Istituto Clinico Città di Brescia, Brescia, Italy.Department of Orthopedics, Istituto Clinico Città di Brescia, Brescia, Italy. Electronic address: bercel1971@gmail.com.Department of Orthopedics, Istituto Clinico Città di Brescia, Brescia, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26952287

Citation

Petriccioli, Dario, et al. "Recovery of Active External Rotation and Elevation in Young Active Men With Irreparable Posterosuperior Rotator Cuff Tear Using Arthroscopically Assisted Latissimus Dorsi Transfer." Journal of Shoulder and Elbow Surgery, vol. 25, no. 9, 2016, pp. e265-75.
Petriccioli D, Bertone C, Marchi G. Recovery of active external rotation and elevation in young active men with irreparable posterosuperior rotator cuff tear using arthroscopically assisted latissimus dorsi transfer. J Shoulder Elbow Surg. 2016;25(9):e265-75.
Petriccioli, D., Bertone, C., & Marchi, G. (2016). Recovery of active external rotation and elevation in young active men with irreparable posterosuperior rotator cuff tear using arthroscopically assisted latissimus dorsi transfer. Journal of Shoulder and Elbow Surgery, 25(9), pp. e265-75. doi:10.1016/j.jse.2015.12.011.
Petriccioli D, Bertone C, Marchi G. Recovery of Active External Rotation and Elevation in Young Active Men With Irreparable Posterosuperior Rotator Cuff Tear Using Arthroscopically Assisted Latissimus Dorsi Transfer. J Shoulder Elbow Surg. 2016;25(9):e265-75. PubMed PMID: 26952287.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recovery of active external rotation and elevation in young active men with irreparable posterosuperior rotator cuff tear using arthroscopically assisted latissimus dorsi transfer. AU - Petriccioli,Dario, AU - Bertone,Celeste, AU - Marchi,Giacomo, Y1 - 2016/03/04/ PY - 2015/08/23/received PY - 2015/12/09/revised PY - 2015/12/14/accepted PY - 2016/3/9/entrez PY - 2016/3/10/pubmed PY - 2017/3/31/medline KW - Irreparable rotator cuff tears KW - arthroscopy KW - electromyography KW - isokinetic dynamometer KW - latissimus dorsi KW - tendon transfer SP - e265 EP - 75 JF - Journal of shoulder and elbow surgery JO - J Shoulder Elbow Surg VL - 25 IS - 9 N2 - BACKGROUND: Massive irreparable posterosuperior rotator cuff tears represent a serious functional disablement for young and active patients in their daily activities. Latissimus dorsi (LD) muscle-tendon transfer can restore elevation and external rotation where supraspinatus and infraspinatus function is lost. MATERIALS AND METHODS: Between 2009 and 2013, 45 consecutive patients underwent arthroscopically assisted LD transfer for an irreparable posterosuperior rotator cuff tear. Thirty-three patients agreed to participate in this retrospective study. For 8 patients, we used a standard passage of the LD through the plane between the infraspinatus-teres minor and the deltoid muscles. For the remaining 25 patients, we transferred the LD tendon in front of the triceps muscle according to a personal described technique. The follow-up period was 35.7 months. Final follow-up included assessment by standard radiographs, bipolar surface electromyography, pain score by visual analog scale, Constant-Murley shoulder score, and Disabilities of the Arm, Shoulder, and Hand score. For quantitative strength evaluation measurements, a Biodex dynamometer was used. RESULTS: Overall clinical outcomes improved at the final follow-up and were significantly age related. We found similar results for revision and primary patients with mean increase in Constant-Murley scores of 29.5 and 30.5 points, respectively. In our series, we recorded osteoarthritis progression in 33.3% of patients. CONCLUSION: Arthroscopic LD tendon transfer for irreparable posterosuperior rotator cuff tears can achieve good clinical outcomes at a midterm follow-up, especially in active men 60 years of age or younger and in patients with low preoperative elevation (<80°) but an intact or reparable subscapularis tendon. SN - 1532-6500 UR - https://www.unboundmedicine.com/medline/citation/26952287/Recovery_of_active_external_rotation_and_elevation_in_young_active_men_with_irreparable_posterosuperior_rotator_cuff_tear_using_arthroscopically_assisted_latissimus_dorsi_transfer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1058-2746(15)00744-2 DB - PRIME DP - Unbound Medicine ER -