Biomechanics of lower trapezius and latissimus dorsi transfers in rotator cuff–deficient shoulders

Reddy, Akhil; Gulotta, Lawrence V.; Chen, Xiang; Castagna, Alessandro; Dines, David M.; Warren, Russell F.; Kontaxis, Andreas

doi:10.1016/j.jse.2018.11.066

Cited by 47 publications

(39 citation statements)

References 17 publications

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“…While the main goal of the tendon transfer is to restore external rotation, recent biomechanical data favours the use of lower trapezius tendon transfer to the infraspinatus insertion because of both stronger abduction and external rotation moment arms. 107 The development of arthroscopic surgery led to an increased awareness and subsequently better understanding of the superior capsule, which is closely related to the undersurface of the supraspinatus and infraspinatus tendons and resists superior migration of the humeral head. 108 Subsequent research showed that a double-layer repair with inherent approximation of the superior capsule leads to improved biomechanical properties of the construct.…”

Section: Rotator Cuffmentioning

confidence: 99%

Shoulder biomechanics in normal and selected pathological conditions

et al. 2020

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The stability of the glenohumeral joint depends on soft tissue stabilizers, bone morphology and dynamic stabilizers such as the rotator cuff and long head of the biceps tendon. Shoulder stabilization techniques include anatomic procedures such as repair of the labrum or restoration of bone loss, but also non-anatomic options such as remplissage or tendon transfers. Rotator cuff repair should restore the cuff anatomy, reattach the rotator cable and respect the coracoacromial arch whenever possible. Tendon transfer, superior capsular reconstruction or balloon implantation have been proposed for irreparable lesions. Shoulder rehabilitation should focus on restoring balanced glenohumeral and scapular force couples in order to avoid an upward migration of the humeral head and secondary cuff impingement. The primary goal of cuff repair is to be as anatomic as possible and to create a biomechanically favourable environment for tendon healing. Cite this article: EFORT Open Rev 2020;5:508-518. DOI: 10.1302/2058-5241.5.200006

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Section: Rotator Cuffmentioning

confidence: 99%

Shoulder biomechanics in normal and selected pathological conditions

et al. 2020

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“…A supraspinatus insertion is normally favored for LD transfer since it provides maximal external rotation with minimal resistance to humeral abduction. 20) Considering the biomechanical aspect, there are assertions that the greater tuberosity is superior to other sites for improving range of motion of the transferred tendon, but, conversely, there is a claim that the additional tenodesis effect is obtained by fixation at the anterior aspect of greater and lesser tuberosity. More than half the active external rotation moment was restored by transferring LD to either supraspinatus or subscapularis insertion.…”

Section: Discussionmentioning

confidence: 99%

Mid-term Clinical and Radiological Outcomes of Latissimus Dorsi Tendon Transfer in Massive Rotator Cuff Tears

Suh

Tankshali

et al. 2019

Clin Shoulder Elbow

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Background: This retrospective study was undertaken to evaluate mid-term clinical and radiological outcomes of lattisimus dorsi (LD) tendon transfer in patients with irreparable massive rotator cuff tears (MRCT). We hypothesize that LD tendon transfer would provide safe and satisfactory clinical outcomes at mid-term follow-up.Methods: From November 2008 to December 2016, 23 patients (57.5 ± 4.4 years; 20 male, 3 female) who underwent LD tendon transfer for massive tears, were enrolled. Inclusion criteria were irreparable MRCT. Exclusion criteria included full thickness subscapularis tear, rotator cuff arthropathy, anterosuperior rotator cuff tear, and osteoarthritis. Mean follow-up period was 4.7 ± 4.0 years (range, 2?12 years). Clinical assessment (American Shoulder and Elbow Surgeons [ASES], University of California, Los Angeles [UCLA], Simple Shoulder Test [SST]) and radiographic assessment (osteoarthritis [OA], acromiohumeral distance [AHI]) were evaluated.Results: ASES, UCLA and SST scores, and range of motion (ROM), except internal rotation, improved significantly at the last follow-up (<i>p</i><0.05). Also, AHI was significantly improved at the last follow-up, from 6.6 mm to 8.2 mm (<i>p</i>=0.008). At the final follow-up, the radiologic stages of the glenohumeral osteoarthritis were determined as stage 1 in 9 patients, stage 2 in 10 patients, stage 3 in 2 patients, and stage 4 in 2 patients. Complications were observed in 21.7% cases: 3 re-tears and 2 infections were noted in our study.Conclusions: LD tendon transfer for irreparable MRCT provides satisfactory clinical outcomes at mid-term follow-up. Mild degenerative osteoarthritis (stage 1, 2) of the shoulder joint are common at the mid-term follow-up. Also, complications such as tear, infection should be considered.

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“…However, since the tendon excursion is short, it is possible to attach the greater tuberosity only by bridging, such as autograft fascia lata or allograft Achilles tendon. Reddy et al [89] recently published a study comparing the biomechanics of LT transfer and LD transfer using three-dimensional images. In this study, the LT showed overall better results than LD transfer due to stronger abduction moment arm.…”

Section: Tendon Transfer: Lower Trapeziusmentioning

confidence: 99%

Surgical Options for Failed Rotator Cuff Repair, except Arthroplasty: Review of Current Methods

Kim

Ryu

Kim

2020

Clin Shoulder Elbow

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Although the prevalence of rotator cuff tears is dependent on the size, 11% to 94% of patients experience retear or healing failure after rotator cuff repair. Treatment of patients with failed rotator cuff repair ranges widely, from conservative treatment to arthroplasty. This review article attempts to summarize the most recent and relevant surgical options for failed rotator cuff repair patients, and the outcomes of each treatment, except arthroplasty.

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Biomechanics of lower trapezius and latissimus dorsi transfers in rotator cuff–deficient shoulders

Cited by 47 publications

References 17 publications

Shoulder biomechanics in normal and selected pathological conditions

Shoulder biomechanics in normal and selected pathological conditions

Mid-term Clinical and Radiological Outcomes of Latissimus Dorsi Tendon Transfer in Massive Rotator Cuff Tears

Surgical Options for Failed Rotator Cuff Repair, except Arthroplasty: Review of Current Methods

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