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The latissimus dorsi tendon functions as an external rotator after arthroscopic-assisted transfer for massive irreparable posterosuperior rotator cuff tears.

Abstract

PURPOSE

Latissimus dorsi tendon transfer is a surgical option for the treatment of massive irreparable posterosuperior rotator cuff tear. Whether a favourable clinical outcome is due to the latissimus dorsi muscle contraction rather than the passive tenodesis effect remains to be confirmed. The purpose of the current case-control study was to evaluate the shoulder kinematics and latissimus dorsi activation after latissimus dorsi tendon transfer.

METHODS

Eighteen patients suffering from irreparable rotator cuff tear that underwent latissimus dorsi tendon transfer and 18 healthy individuals were examined using a 3D kinematic tracking system and electromyography. Active maximal flexion-extension and abduction-adduction of the humerus were measured for the operated and the contralateral shoulder of the patients and the shoulder of healthy individuals to evaluate the range of motion (ROM) and scapulohumeral rhythm. Electromyographic comparison of isometric contraction between the latissimus dorsi of the operated and contralateral shoulder was carried out.

RESULTS

After arthroscopic-assisted latissimus dorsi tendon transfer, patients showed comparable flexion and abduction ROM to their asymptomatic contralateral shoulders and to the shoulders of healthy individuals. Significantly higher scapular ROM values were found between the latissimus dorsi tendon transfer side and the shoulders of healthy individuals. While performing external rotation with 0° shoulder abduction, a greater percentage of the electromyographic peak value (p = 0.047) and a higher latissimus dorsi internal/external rotation ratio (p = 0.004) were noted for the transferred muscle in comparison to the contralateral shoulder.

CONCLUSION

Although the arthroscopic-assisted latissimus dorsi tendon transfer failed to normalize scapulothoracic joint movements of patients, a functional latissimus flap and a shoulder ROM similar to the contralateral side or the shoulder of healthy individuals can be expected after this procedure in patients with massive irreparable posterosuperior rotator cuff tear.

LEVEL OF EVIDENCE

III.

Authors+Show Affiliations

Department of Orthopedic and Trauma Surgery, "Mater Domini" University Hospital, "Magna Græcia" University, V.le Europa (loc. Germaneto), 88100, Catanzaro, Italy.NCS Lab, Via Pola Esterna 4/12, 41012, Carpi, MO, Italy.NCS Lab, Via Pola Esterna 4/12, 41012, Carpi, MO, Italy. Department of Electrical, Electronic and Information Engineering, University of Bologna, Viale del Risorgimento, 2, 40136, Bologna, Italy.NCS Lab, Via Pola Esterna 4/12, 41012, Carpi, MO, Italy.Division of Orthopedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.Division of Orthopedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.Department of Orthopedic and Trauma Surgery, "Mater Domini" University Hospital, "Magna Græcia" University, V.le Europa (loc. Germaneto), 88100, Catanzaro, Italy. gasparini@unicz.it.Division of Orthopedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31811355

Citation

Galasso, Olimpio, et al. "The Latissimus Dorsi Tendon Functions as an External Rotator After Arthroscopic-assisted Transfer for Massive Irreparable Posterosuperior Rotator Cuff Tears." Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 2019.
Galasso O, Mantovani M, Muraccini M, et al. The latissimus dorsi tendon functions as an external rotator after arthroscopic-assisted transfer for massive irreparable posterosuperior rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2019.
Galasso, O., Mantovani, M., Muraccini, M., Berardi, A., De Benedetto, M., Orlando, N., ... Castricini, R. (2019). The latissimus dorsi tendon functions as an external rotator after arthroscopic-assisted transfer for massive irreparable posterosuperior rotator cuff tears. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, doi:10.1007/s00167-019-05819-2.
Galasso O, et al. The Latissimus Dorsi Tendon Functions as an External Rotator After Arthroscopic-assisted Transfer for Massive Irreparable Posterosuperior Rotator Cuff Tears. Knee Surg Sports Traumatol Arthrosc. 2019 Dec 6; PubMed PMID: 31811355.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The latissimus dorsi tendon functions as an external rotator after arthroscopic-assisted transfer for massive irreparable posterosuperior rotator cuff tears. AU - Galasso,Olimpio, AU - Mantovani,Matteo, AU - Muraccini,Marco, AU - Berardi,Antonella, AU - De Benedetto,Massimo, AU - Orlando,Nicola, AU - Gasparini,Giorgio, AU - Castricini,Roberto, Y1 - 2019/12/06/ PY - 2019/05/28/received PY - 2019/11/27/accepted PY - 2019/12/8/entrez PY - 2019/12/8/pubmed PY - 2019/12/8/medline KW - Electromyography KW - Latissimus dorsi KW - Magnetic and inertial sensors KW - Massive irreparable rotator cuff tear KW - Muscular activity KW - Shoulder kinematics KW - Tendon transfer JF - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA JO - Knee Surg Sports Traumatol Arthrosc N2 - PURPOSE: Latissimus dorsi tendon transfer is a surgical option for the treatment of massive irreparable posterosuperior rotator cuff tear. Whether a favourable clinical outcome is due to the latissimus dorsi muscle contraction rather than the passive tenodesis effect remains to be confirmed. The purpose of the current case-control study was to evaluate the shoulder kinematics and latissimus dorsi activation after latissimus dorsi tendon transfer. METHODS: Eighteen patients suffering from irreparable rotator cuff tear that underwent latissimus dorsi tendon transfer and 18 healthy individuals were examined using a 3D kinematic tracking system and electromyography. Active maximal flexion-extension and abduction-adduction of the humerus were measured for the operated and the contralateral shoulder of the patients and the shoulder of healthy individuals to evaluate the range of motion (ROM) and scapulohumeral rhythm. Electromyographic comparison of isometric contraction between the latissimus dorsi of the operated and contralateral shoulder was carried out. RESULTS: After arthroscopic-assisted latissimus dorsi tendon transfer, patients showed comparable flexion and abduction ROM to their asymptomatic contralateral shoulders and to the shoulders of healthy individuals. Significantly higher scapular ROM values were found between the latissimus dorsi tendon transfer side and the shoulders of healthy individuals. While performing external rotation with 0° shoulder abduction, a greater percentage of the electromyographic peak value (p = 0.047) and a higher latissimus dorsi internal/external rotation ratio (p = 0.004) were noted for the transferred muscle in comparison to the contralateral shoulder. CONCLUSION: Although the arthroscopic-assisted latissimus dorsi tendon transfer failed to normalize scapulothoracic joint movements of patients, a functional latissimus flap and a shoulder ROM similar to the contralateral side or the shoulder of healthy individuals can be expected after this procedure in patients with massive irreparable posterosuperior rotator cuff tear. LEVEL OF EVIDENCE: III. SN - 1433-7347 UR - https://www.unboundmedicine.com/medline/citation/31811355/The_latissimus_dorsi_tendon_functions_as_an_external_rotator_after_arthroscopic_assisted_transfer_for_massive_irreparable_posterosuperior_rotator_cuff_tears_ L2 - https://dx.doi.org/10.1007/s00167-019-05819-2 DB - PRIME DP - Unbound Medicine ER -