Biomechanical effectiveness of different types of tendon transfers to the shoulder for external rotation

Hartzler, Robert U.; Barlow, Jonathan D.; An, Kai Nan; Elhassan, Bassem T.

doi:10.1016/j.jse.2012.01.026

Cited by 95 publications

(66 citation statements)

References 29 publications

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“…In addition, for TM, transfer to the supraspinatus insertion is better than transfer to the infraspinatus insertion [7,36]. & In a cadaveric study, Hartzler et al [37] showed that the lower part of the trapezius had a higher effect than the LD tendon or the TM tendon for restoring external rotation moment arm.…”

Section: Introductionmentioning

confidence: 99%

Latissimus dorsi tendon transfer for irreparable postero-superior cuff tears: current concepts, indications, and recent advances

Grimberg

Kany

2014

Curr Rev Musculoskelet Med

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Latissimus dorsi tendon transfer is a method for surgical treatment of massive irreparable posterosuperior cuff tears. It partially restores active anteflexion, external rotation, and function of the shoulder but does not significantly increase strength of the shoulder. It is contraindicated in case of pseudoparalytic shoulder; associated irreparable subscapularis tear, deltoid palsy, and in case of associated osteoarthritis, as an isolated procedure. Results are inferior when performed as a secondary procedure compared with a primary procedure. However, latissimus dorsi tendon transfer is an attractive solution to improve shoulder mobility and function of young and non osteoarthritic patients whose previous surgical treatment of massive postero-superior irreparable rotator cuff tear failed. As a primary procedure, latissimus dorsi tendon transfer competes with debridement, biceps tenotomy, and partial cuff repair. In association with reverse shoulder arthroplasty, it restores active external rotation in osteoarthritic patients with active external rotation deficit. New arthroscopic assisted techniques might improve results in the future.

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Section: Introductionmentioning

confidence: 99%

Latissimus dorsi tendon transfer for irreparable postero-superior cuff tears: current concepts, indications, and recent advances

Grimberg

Kany

2014

Curr Rev Musculoskelet Med

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“…Hartzler et al 1 conducted a biomechanical laboratory study to compare the external rotation moment arm among latissimus dorsi, teres major, and LTT to selected locations on the proximal humerus. The authors found that the LTT resulted in superior restoration of the shoulder external rotation at 0 of abduction compared with the latissimus dorsi or teres major, particularly if transferred to the infraspinatus.…”

Section: Discussionmentioning

confidence: 99%

“…When considering the different transfer options, a recent biomechanical study showed that the lower trapezius has better moment arm of external rotation compared with latissimus dorsi and teres major transfer. 1 In addition, the clinical outcomes of open LTT in a series of 33 patients with massive irreparable posteriorsuperior rotator cuff tears have been successful. 2 Therefore, the senior author's (B.T.E.)…”

mentioning

confidence: 96%

Arthroscopic-Assisted Lower Trapezius Tendon Transfer for Massive Irreparable Posterior-Superior Rotator Cuff Tears: Surgical Technique

Elhassan

Alentorn-Geli

Assenmacher

et al. 2016

Arthroscopy Techniques

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Tendon transfer options to reconstruct a massive irreparable posterior-superior rotator cuff tear include latissimus dorsi, teres major, or lower trapezius transfer. We previously described the lower trapezius transfer using a 2-incision approach, which includes a medial incision to harvest the lower trapezius and lateral transacromial incision to expose the rotator cuff and then perform the transfer through a deep tunnel connecting these 2 sites. In this report, we describe an arthroscopic-assisted technique of lower trapezius transfer augmented with an Achilles tendon allograft to reconstruct an irreparable posterior-superior rotator cuff tear.

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“…Its use was first described by Elhassan et al to improve external rotation in patients with brachial plexopathy [85]. A biomechanical investigation found that a lower trapezius transfer is more effective in restoring external rotation than the latissimus dorsi transfer [86]. In 2016 Elhassan et al published their results of lower trapezius transfer with Achilles tendon augmentation at an average follow-up of 47 months [87].…”

Section: Tendon Transfersmentioning

confidence: 99%

Options Before Reverse Total Shoulder Replacement

Hackney¹,

Lesniewski²,

Cowling³

2018

Advances in Shoulder Surgery

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Management of massive tears of the rotator cuff tears is one of the most difficult problems an upper limb surgeon encounters. Patients with similar tears can present with minimal discomfort through to a flail shoulder. There are a bewildering number of options available, many with published outcomes not always borne out in clinical practise. These range from rehabilitation, simple arthroscopic surgery, attempts at repair, complex tendon transfers and ultimately a reverse total shoulder replacement. More recently further options of patch augmentation and balloon arthroplasty have been added. This paper attempts to provide a critical assessment of the evidence available.

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Biomechanical effectiveness of different types of tendon transfers to the shoulder for external rotation

Cited by 95 publications

References 29 publications

Latissimus dorsi tendon transfer for irreparable postero-superior cuff tears: current concepts, indications, and recent advances

Latissimus dorsi tendon transfer for irreparable postero-superior cuff tears: current concepts, indications, and recent advances

Arthroscopic-Assisted Lower Trapezius Tendon Transfer for Massive Irreparable Posterior-Superior Rotator Cuff Tears: Surgical Technique

Options Before Reverse Total Shoulder Replacement

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