Latissimus dorsi transfer for treatment of massive and irreparable rotator cuff injuries.
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Published:
Jul 28, 2017
Keywords:
, Massive rupture / Rotator cuff, Tendon transfer, Lattisimus dorsi.
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Abstract
Introduction: The aim of the study is to analyze the clinical and radiological outcomes of a series of patients with massive ruptures of the rotator cuff treated with latissimus dorsi tendon transfer.Materials and Methods: Inclusion criteria: 1) Less than 70 years-old 2) Postero-superior rotator cuff rupture 3) Loss of strength in external rotation and abduction 4) MRI showing massive retraction injury grade III-IV of Patte 5) No response to conservative treatment 6) Healthy contralateral shoulder, 7) Treated with latissimus dorsi transfer and 8) More than two years of follow-up. Mobility and strength in abduction were assessed. Furthermore, the Visual Analog Scale (VAS) and the modified Constant-Murley were recorded. The acromion-humeral distance and the degree of arthropathy was radiographically examined. Complications and reoperation were recorded.Results: Seventeen patients were included. Twelve men and 5 women. The average age was 54 years (34-65). The average follow-up of 46 months (24-71). They were evaluated in two groups, primary and revision surgery. In the primary surgery group, the average mobility in anterior flexion was 53°, 50° abduction and external rotation of 19º. The force abducted an average gain of 1.4 kg. The postoperative VAS improved by 5.1 points from the preoperative average. The Constant-Murley scale of 75.6 (63 to 80) at the end of follow up. In the revision group, the average mobility in anterior flexion was 48º, 30° abduction and external rotation of 10º. The force abducted an average gain of 1.1 kg. The postoperative VAS improved by 3.4 points from the preoperative average. The Constant-Murley scale of 55.2 (50.3-65.1) at the end of follow upConclusion: Latissimus dorsi tendon transfer for the treatment of massive rupture of the rotator cuff showed improvements in range of motion, strength, pain relief and shoulder function.
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Zaidenberg, C. R., Zaidenberg, E. E., Pastrana, M. J., & Francisco, F. (2017). Latissimus dorsi transfer for treatment of massive and irreparable rotator cuff injuries. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 82(3), 182-188. https://doi.org/10.15417/548
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Clinical Research
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References
Referencias:
1. Burkhart SS. Arthrocopic treatment of massive rotator cuff tears. Clinical results and biomechanical rationale . Clin Orthop Relat Res. 1991; 267: 45-56
2. Cofield RH. Rotator cuff disease of the shoulder. J Bone Joint Surg Am. 1985;67:974–9.
3. Neer CS. Anatomy of shoulder reconstruction. In: Neer CS, ed. Shoulder reconstruction. Philadelphia, etc: W. B. Saunders Company, 1990:1-39.
4. Ozaki J, Fujimoto S, Masuhara K, Tamai S, Yoshimoto S. Reconstruction of chronic massive rotator cuff tears with synthetic materials. Clin Orthop Relat Res 1986;202:173-83.
5. Rockwood Jr CA, Williams Jr GR, Burkhead Jr WZ: Debridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg 77A:857–866, 1995.
6. Gerber C, Maquieira G, Espinosa N. Latissimus dorsi transfer for the treatment of irreparable rotator cuff tears. J Bone Joint Surg Am. 2006;88:113-20.
7. Scheibel M, Lichtenberg S, Habermeyer P. Reversed arthroscopic subacromial decompression for massive rotator cuff tears. J Should Elb Surg. 2005;13:272–8.
8. Constant CR, Murley AHG: A clinical method functional assess ment of the shoulder. Clin Orthop 214:160–164, 1987.
9. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990; 254:92-6.
10. Gerber C, Vinh TS, Hertel R, Hess CW. Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff. A preliminary report. Clin Orthop Relat Res. 1988;232:51–61
11. Vanhove B, Beugnies A: Grammont’s reverse shoulder prosthesis for rotator cuff arthropathy: A retrospective study of 32 cases. Acta Orthop Belg 2004; 70(3):219-225.
12. Walch G, Wall B, Mottier F: Complications and revision of the reverse prosthesis: A multicenter study of 457 cases, in Walch G, Boileau P, Molé P, Favard L, Lévigne C, Sirveaux F, eds: Reverse Shoulder Arthroplasty: Clinical Results, Complications, Revision. Complications in Reverse Total Shoulder Arthroplasty. Montpellier, France, Sauramps Médical, 2006, pp 335-352.
13. Gerber C, Pennington SD, Nyffeler RW: Reverse total shoulder arthroplasty. J Am Acad Orthop Surg 2009;17(5):284-295.
14. l’Episcopo JB. Tendon transplantation in obstetrical paralysis. Am J Surg 1934; 25:122–125.
15. Berth A, NeumannW, Awiszus F, Pap G. Massive rotator cuff tears: functional outcome after debridement vs arthroscopic partial repair. J Orthop Traumatol. 2010;11:13–20.
16. Audenaert E, Van Nuffel J, Schepens A, Verhelst M, Verdonk R. Reconstruction of massive rotator cuff lesions with a synthetic interposition graft: a prospective study of 41 patients. Knee Surg Sports Traumatol Arthrosc. 2006;14:360–4.
17. Warner JJ, Parsons Im IV. Latissimus dorsi tendon transfer: a comparative analysis of primary and salvage reconstruction of massive, irreparable rotator cuff tears. J Shoulder Elbow Surg 2001;10: 514-21.
18. El-Azab HM, Rott O, Irlenbusch U. Long-term follow-up after lattisimus dorsi transfer for irreparable posterosuperior rotator cuff tears. J Bone Joint Surg Am. 2015 Mar 18;97(6):462-9.
1. Burkhart SS. Arthrocopic treatment of massive rotator cuff tears. Clinical results and biomechanical rationale . Clin Orthop Relat Res. 1991; 267: 45-56
2. Cofield RH. Rotator cuff disease of the shoulder. J Bone Joint Surg Am. 1985;67:974–9.
3. Neer CS. Anatomy of shoulder reconstruction. In: Neer CS, ed. Shoulder reconstruction. Philadelphia, etc: W. B. Saunders Company, 1990:1-39.
4. Ozaki J, Fujimoto S, Masuhara K, Tamai S, Yoshimoto S. Reconstruction of chronic massive rotator cuff tears with synthetic materials. Clin Orthop Relat Res 1986;202:173-83.
5. Rockwood Jr CA, Williams Jr GR, Burkhead Jr WZ: Debridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg 77A:857–866, 1995.
6. Gerber C, Maquieira G, Espinosa N. Latissimus dorsi transfer for the treatment of irreparable rotator cuff tears. J Bone Joint Surg Am. 2006;88:113-20.
7. Scheibel M, Lichtenberg S, Habermeyer P. Reversed arthroscopic subacromial decompression for massive rotator cuff tears. J Should Elb Surg. 2005;13:272–8.
8. Constant CR, Murley AHG: A clinical method functional assess ment of the shoulder. Clin Orthop 214:160–164, 1987.
9. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990; 254:92-6.
10. Gerber C, Vinh TS, Hertel R, Hess CW. Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff. A preliminary report. Clin Orthop Relat Res. 1988;232:51–61
11. Vanhove B, Beugnies A: Grammont’s reverse shoulder prosthesis for rotator cuff arthropathy: A retrospective study of 32 cases. Acta Orthop Belg 2004; 70(3):219-225.
12. Walch G, Wall B, Mottier F: Complications and revision of the reverse prosthesis: A multicenter study of 457 cases, in Walch G, Boileau P, Molé P, Favard L, Lévigne C, Sirveaux F, eds: Reverse Shoulder Arthroplasty: Clinical Results, Complications, Revision. Complications in Reverse Total Shoulder Arthroplasty. Montpellier, France, Sauramps Médical, 2006, pp 335-352.
13. Gerber C, Pennington SD, Nyffeler RW: Reverse total shoulder arthroplasty. J Am Acad Orthop Surg 2009;17(5):284-295.
14. l’Episcopo JB. Tendon transplantation in obstetrical paralysis. Am J Surg 1934; 25:122–125.
15. Berth A, NeumannW, Awiszus F, Pap G. Massive rotator cuff tears: functional outcome after debridement vs arthroscopic partial repair. J Orthop Traumatol. 2010;11:13–20.
16. Audenaert E, Van Nuffel J, Schepens A, Verhelst M, Verdonk R. Reconstruction of massive rotator cuff lesions with a synthetic interposition graft: a prospective study of 41 patients. Knee Surg Sports Traumatol Arthrosc. 2006;14:360–4.
17. Warner JJ, Parsons Im IV. Latissimus dorsi tendon transfer: a comparative analysis of primary and salvage reconstruction of massive, irreparable rotator cuff tears. J Shoulder Elbow Surg 2001;10: 514-21.
18. El-Azab HM, Rott O, Irlenbusch U. Long-term follow-up after lattisimus dorsi transfer for irreparable posterosuperior rotator cuff tears. J Bone Joint Surg Am. 2015 Mar 18;97(6):462-9.