Arthroscopic-assisted latissimus dorsi transfer for subscapularis deficiency

Kany, Jean; Guinand, R.; Croutzet, Pierre; Valenti, Philippe; Werthel, Jean David; Grimberg, Jean

doi:10.1007/s00590-016-1753-3

Cited by 61 publications

(40 citation statements)

References 17 publications

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“…Overall, of the 208 patients for which the CS was reported both preoperatively and postoperatively, the mean score increased from 34.4 ± 8.2 (range, 10-55) preoperatively to 66.0 ± 15.6 (range, 13-92) postoperatively. One study 20 (n = 5) used the subjective shoulder value to measure outcomes of LDTT ; the mean subjective shoulder value increased from 20.0 (SD and range not reported) preoperatively to 56.0 (SD and range not reported) postoperatively overall, but with the removal of the participant whose outcome was complicated by a deep infection, the mean score increased from 18.8 (SD and range not reported) to 62.5 (SD and range not reported). The University of California, Los Angeles (UCLA) shoulder scale was used to evaluate outcomes of 15 patients and demonstrated an increase in the mean score from 6.5 ± 4.2 (range, 4-11) to 27.5 ± 6.3 (range, 8-34) preoperatively to postoperatively.…”

Section: Resultsmentioning

confidence: 99%

“… 27 Additionally, in patients with posterosuperior rotator cuff tears and resulting loss of supraspinatus and infraspinatus function, LDTT has been shown to decrease pain and restore elevation and external rotation. 14 , 27 This procedure is promising for cases in which ruptured subscapularis or supraspinatus and infraspinatus tendons have retracted beyond surgical repair or those in which other attempts at surgical repair have failed, 4 , 14 , 19 , 20 , 27 , 36 the deltoid is functioning and there are no neurological deficits, 19 , 25 and there is an absence of moderate or severe glenohumeral osteoarthritis such that arthroplasty may be the indicated procedure. 19 , 25 For the repair of posterosuperior tears, it is generally required that the subscapularis tendon is intact or repairable to provide sufficient rotational force coupling around the shoulder joint.…”

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confidence: 99%

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Arthroscopic-Assisted Latissimus Dorsi Tendon Transfer for Massive Rotator Cuff Tears: A Systematic Review

Memon

Kay

Quick

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Arthroscopic-assisted latissimus dorsi tendon transfer (LDTT) has shown promising results with good outcomes in patients with massive rotator cuff tears (MRCTs), as reported by individual studies. However, to the best of the authors’ knowledge, no systematic review has been performed to assess the collective outcomes of these individual studies.Purpose/Hypothesis:The primary purpose of this study was to assess patient outcomes after arthroscopic-assisted LDTT for the management of MRCTs. The secondary objectives were to report on the management of MRCTs, including diagnostic investigations, surgical decision making, and arthroscopic techniques, as well as to evaluate the quality of evidence of the existing literature. It was hypothesized that nearly all patients were satisfied with arthroscopic-assisted LDTT and that they experienced improvements in pain symptoms, function, and strength after the procedure, with an overall complication rate of less than 10%.Study Design:Systematic review; Level of evidence, 4.Methods:The databases MEDLINE, Embase, and PubMed were searched from database inception (1946) until August 18, 2017, with titles, abstracts, and full-text articles screened independently by 2 reviewers. Inclusion criteria were English-language studies investigating arthroscopic-assisted LDTT for the management of MRCTs on patients of all ages. Conference papers, book chapters, review articles, and technical reports were excluded. The quality of the included studies was categorized by level of evidence and the Methodological Index for Non-Randomized Studies (MINORS) checklist.Results:In total, 8 studies (7 case series [median MINORS score, 7 of 16] and 1 prospective comparative study [median MINORS score, 14 of 24]) were identified; the studies included 258 patients (258 shoulders) with MRCTs treated with LDTT using arthroscopic-assisted techniques. The decision to pursue surgery was based on both clinical findings and investigations in 5 studies, investigations only in 2 studies, and clinical findings only in 1 study. Overall, 88% of patients were satisfied with the results of surgery and experienced significant improvement in their symptoms, including shoulder pain, strength, range of motion, and overall function, over a mean follow-up period of 34.3 months. Overall, there was a low rate of complications (7%) associated with the procedure.Conclusion:Arthroscopic-assisted LDTT for MRCTs provides patients with marked improvement in shoulder pain, strength, and function, and the procedure is associated with a low risk of complication. Further high-quality comparative studies are warranted to validate these findings in comparison with other operative techniques.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Arthroscopic-Assisted Latissimus Dorsi Tendon Transfer for Massive Rotator Cuff Tears: A Systematic Review

Memon

Kay

Quick

et al. 2018

Orthopaedic Journal of Sports Medicine

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“…Not only are the massive tears difficult to repair, unreliable on outcome and there is always a propensity to re-tear. We would like to cover the entire spectrum of management of massive tears from primary repairs by Bancha Cherunchujit and Lat dorsi transfers by Jean Kany who is an expert and has extensive experience on Lat dorsi transfers [6] . Beyond the feasibility of repairs, the surgeon always grapples to choose between Lat dorsi transfer, Synthetic graft and superior capsule reconstruction.…”

Section: Rotator Cuff Tear and Its Challengesmentioning

confidence: 99%

Rotator Cuff Tear and its Challenges

Babhulkar

2019

International Journal of Orthopaedics

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“…[18][19][20] In recent years, both LDT and LTT transfer techniques have been modified to include arthroscopicassisted techniques for anchoring the tendon into the greater tuberosity, thus avoiding the need for an acromial osteotomy or deltoid take-down. [21][22][23][24][25] This is particularly important given the controversy that a certain number of patients will not respond well after open LDT transfers in many series. 17 26 27 Furthermore, the outcomes of arthroscopicassisted LTT have not been reported.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic lower trapezius tendon transfer provides equivalent outcomes to latissimus dorsi transfer in the treatment of massive posterosuperior rotator cuff tears

et al. 2020

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ObjectivesThe purpose of this study is to compare early postoperative recovery following open and arthroscopic-assisted latissimus dorsi tendon (aa-LDT) transfer to arthroscopic-assisted lower trapezius tendon (aa-LTT) transfer for patients with massive irreparable posterosuperior rotator cuff pathology.MethodsA multicentre retrospective analysis comparing the postoperative outcomes after open LDT, arthroscopic-assisted LDT (aa-LDT) or arthroscopic-assisted LTT (aa-LTT) was performed. Active range of motion and patient-reported subjective outcomes were reported preoperatively and postoperatively. Overall, there were 10 patients who underwent open LDT transfer, 16 aaLDT transfers and 8 aa-LTT transfers with mean age of 55±3, 57±6 and 53±13, respectively. Mean follow-up was 22±10 months.ResultsArthroscopic-assisted LDT had significantly improved postoperative forward flexion (85–124, p<0.003) and external rotation (29–38, p<0.005), whereas aa-LTT had significantly improved postoperative forward flexion (101–146, p<0.04). Arthroscopic-assisted LDT and aa-LTT transfers improved American Shoulder and Elbow Surgeons (ASES) Shoulder Function scores and Single Assessment Numeric Evaluation (SANE) at 2 years (p<0.03). Arthroscopic-assisted LTT compared with open LDT demonstrated significantly improved ASES Shoulder Index score (20.0 vs 12.6; 84.8 vs 55.6) and visual analogue scale (VAS) (0.66 vs 4.14; 1.17 vs 3.88) at postoperative 6 months and 2 years, respectively. Arthroscopic-assisted LDT transfer compared with open LDT had improved VAS at 6 months (0.66 vs 2.11, p<0.05). In total, 6 (17.6%) complications were noted. These included two infections with Cutibacterium acnes, two axillary nerve injuries, complex regional pain syndrome and a postsurgical adhesive capsulitis.ConclusionsArthroscopic-assisted LDT and aa-LTT transfers provided improvement in pain and function at 2-year follow-up. The aa-LTT transfer provided significantly improved outcomes at 2 years compared with the open-LDT (latissimus dorsi tendon transfer) transfer. This study demonstrates superiority of arthroscopic-assisted tendon transfer techniques over traditional open techniques while establishing the aa-LTT transfer as a safe and effective alternative in the management of massive irreparable rotator cuff tears.Level of evidenceIV.

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Arthroscopic-assisted latissimus dorsi transfer for subscapularis deficiency

Abstract: Level IV-a, case series.

Cited by 61 publications

References 17 publications

Arthroscopic-Assisted Latissimus Dorsi Tendon Transfer for Massive Rotator Cuff Tears: A Systematic Review

Arthroscopic-Assisted Latissimus Dorsi Tendon Transfer for Massive Rotator Cuff Tears: A Systematic Review

Rotator Cuff Tear and its Challenges

Arthroscopic lower trapezius tendon transfer provides equivalent outcomes to latissimus dorsi transfer in the treatment of massive posterosuperior rotator cuff tears

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