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Achilles tendon allograft-augmented latissimus dorsi tendon transfer for the treatment of massive irreparable posterosuperior rotator cuff tears.
Arch Orthop Trauma Surg 2018; 138(9):1207-1212AO

Abstract

INTRODUCTION

The purpose of this study was to investigate clinical outcomes following Achilles tendon allograft-augmented latissimus dorsi tendon transfer (LDTT) for the treatment of irreparable posterosuperior rotator cuff tears with a minimum of 2 years post-operative follow-up. We hypothesized that patients would show significant improvement in outcomes scores with a low failure rate.

MATERIALS AND METHODS

Patients who were treated with Achilles tendon allograft-augmented LDTT for irreparable posterosuperior rotator cuff tears with a minimum follow-up of 2 years were included. Patient-reported outcomes scores, including ASES, QuickDASH, SANE, SF-12 PCS, and satisfaction, were collected pre- and post-operatively. Pre- and post-operative scores were compared with a Wilcoxon test. Revision to reverse total shoulder arthroplasty (RTSA) was considered as failure.

RESULTS

Between March 2006 and November 2014, a total of 16 patients with a mean age of 49 years (range 34-57 years) were included. Minimum 2-year outcomes data were available for 14 of the 16 patients (87.5%) with a mean follow-up of 5.5 years (range 2.1-10.5 years). Two patients (12.5%) advanced to RTSA at a mean of 1.1 years following LDTT. Postoperative median subjective outcomes scores improved, but did not reach statistical significance (SF-12 PCS: 35.4-46.4, P = 0.182; ASES: 47.5-69.9, P = 0.209; QuickDASH: 57.9-31.8, P = 0.176; SANE: 40.0-39.5, P = 0.273). Median post-operative patient satisfaction was 5 on a 10-point scale (range 1-10).

CONCLUSION

Patients with irreparable rotator cuff tears treated with Achilles tendon allograft-augmented latissimus dorsi tendon transfer did not experience significant post-operative improvement in patient-reported outcomes. Thus, the use of an additional allograft-augmentation remains questionable.

LEVEL OF EVIDENCE

Retrospective case series, level IV.

Authors+Show Affiliations

Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA.Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA.Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA. The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA.Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA.Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA.Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA. drmillett@thesteadmanclinic.com. The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA. drmillett@thesteadmanclinic.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29876638

Citation

Pogorzelski, Jonas, et al. "Achilles Tendon Allograft-augmented Latissimus Dorsi Tendon Transfer for the Treatment of Massive Irreparable Posterosuperior Rotator Cuff Tears." Archives of Orthopaedic and Trauma Surgery, vol. 138, no. 9, 2018, pp. 1207-1212.
Pogorzelski J, Horan MP, Godin JA, et al. Achilles tendon allograft-augmented latissimus dorsi tendon transfer for the treatment of massive irreparable posterosuperior rotator cuff tears. Arch Orthop Trauma Surg. 2018;138(9):1207-1212.
Pogorzelski, J., Horan, M. P., Godin, J. A., Hussain, Z. B., Fritz, E. M., & Millett, P. J. (2018). Achilles tendon allograft-augmented latissimus dorsi tendon transfer for the treatment of massive irreparable posterosuperior rotator cuff tears. Archives of Orthopaedic and Trauma Surgery, 138(9), pp. 1207-1212. doi:10.1007/s00402-018-2943-8.
Pogorzelski J, et al. Achilles Tendon Allograft-augmented Latissimus Dorsi Tendon Transfer for the Treatment of Massive Irreparable Posterosuperior Rotator Cuff Tears. Arch Orthop Trauma Surg. 2018;138(9):1207-1212. PubMed PMID: 29876638.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Achilles tendon allograft-augmented latissimus dorsi tendon transfer for the treatment of massive irreparable posterosuperior rotator cuff tears. AU - Pogorzelski,Jonas, AU - Horan,Marilee P, AU - Godin,Jonathan A, AU - Hussain,Zaamin B, AU - Fritz,Erik M, AU - Millett,Peter J, Y1 - 2018/06/06/ PY - 2017/11/12/received PY - 2018/6/8/pubmed PY - 2019/4/26/medline PY - 2018/6/8/entrez KW - Irreparable tear KW - Latissimus dorsi KW - Rotator cuff KW - Tendon transfer SP - 1207 EP - 1212 JF - Archives of orthopaedic and trauma surgery JO - Arch Orthop Trauma Surg VL - 138 IS - 9 N2 - INTRODUCTION: The purpose of this study was to investigate clinical outcomes following Achilles tendon allograft-augmented latissimus dorsi tendon transfer (LDTT) for the treatment of irreparable posterosuperior rotator cuff tears with a minimum of 2 years post-operative follow-up. We hypothesized that patients would show significant improvement in outcomes scores with a low failure rate. MATERIALS AND METHODS: Patients who were treated with Achilles tendon allograft-augmented LDTT for irreparable posterosuperior rotator cuff tears with a minimum follow-up of 2 years were included. Patient-reported outcomes scores, including ASES, QuickDASH, SANE, SF-12 PCS, and satisfaction, were collected pre- and post-operatively. Pre- and post-operative scores were compared with a Wilcoxon test. Revision to reverse total shoulder arthroplasty (RTSA) was considered as failure. RESULTS: Between March 2006 and November 2014, a total of 16 patients with a mean age of 49 years (range 34-57 years) were included. Minimum 2-year outcomes data were available for 14 of the 16 patients (87.5%) with a mean follow-up of 5.5 years (range 2.1-10.5 years). Two patients (12.5%) advanced to RTSA at a mean of 1.1 years following LDTT. Postoperative median subjective outcomes scores improved, but did not reach statistical significance (SF-12 PCS: 35.4-46.4, P = 0.182; ASES: 47.5-69.9, P = 0.209; QuickDASH: 57.9-31.8, P = 0.176; SANE: 40.0-39.5, P = 0.273). Median post-operative patient satisfaction was 5 on a 10-point scale (range 1-10). CONCLUSION: Patients with irreparable rotator cuff tears treated with Achilles tendon allograft-augmented latissimus dorsi tendon transfer did not experience significant post-operative improvement in patient-reported outcomes. Thus, the use of an additional allograft-augmentation remains questionable. LEVEL OF EVIDENCE: Retrospective case series, level IV. SN - 1434-3916 UR - https://www.unboundmedicine.com/medline/citation/29876638/Achilles_tendon_allograft_augmented_latissimus_dorsi_tendon_transfer_for_the_treatment_of_massive_irreparable_posterosuperior_rotator_cuff_tears_ L2 - https://dx.doi.org/10.1007/s00402-018-2943-8 DB - PRIME DP - Unbound Medicine ER -