Clinical and Radiographic Outcomes With Assessment of the Learning Curve in Arthroscopically Assisted Latissimus Dorsi Tendon Transfer for Irreparable Posterosuperior Rotator Cuff Tears

Yamakado, Kotaro

doi:10.1016/j.arthro.2017.06.015

Cited by 25 publications

(21 citation statements)

References 22 publications

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“…In our article, that number was basically 10 cases. Yamakado 4 shows a similar finding in Figures 5 and 6. This is considered to be a lengthy learning curve, and when applied to a small number of cases on an annual basis, it may take a surgeon several years to become proficient with aLD.…”

Section: See Related Article On Page 2144supporting

confidence: 83%

See 1 more Smart Citation

Editorial Commentary: When the Shoulder Joint Has Lost Stoichiometry—Does Arthroscopic-Assisted Latissimus Dorsi Transfer Stack Up?

Graham

2017

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: See Related Article On Page 2144supporting

confidence: 83%

“…I say analogous to giving the deltoid an AFR of 12. 4 nicely describes the technique, outcomes, and learning curve for this procedure. The surgical technique is described very well and beautifully enhanced with nice surgical pictures in the figures.…”

Section: See Related Article On Page 2144mentioning

confidence: 99%

Editorial Commentary: When the Shoulder Joint Has Lost Stoichiometry—Does Arthroscopic-Assisted Latissimus Dorsi Transfer Stack Up?

Graham

2017

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“… 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.…”

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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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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“…In a multicenter series, Grimberg et al [ 8 ] reported similarly good outcomes in 55 patients at a mean of 29 months postoperatively. More recently, Yamakado [ 13 ] also reported good outcomes in 30 patients at 37 months. Kanatlı et al [ 14 ] reported outcomes for this technique in patients with pseudoparalysis, and showed significant improvements in active forward elevation from 58° to 130° ( p <0.001) in 15 patients at a mean 26 months postoperatively, which suggested the technique may be indicated in patients with pseudoparalysis.…”

Section: Discussionmentioning

confidence: 99%

“…A literature review revealed only four original articles and two technical notes [ 11 , 12 ] have reported outcomes after arthroscopic-assisted LD transfer and showed its effectiveness for treating massive, irreparable rotator cuff tears ( Table 4 ) [ 8 , 9 , 13 , 14 ]. Castricini et al [ 9 ] demonstrated clinical improvements in pain, Constant scores, muscle strength in forward elevation, and range of motion in 27 patients at a mean 27 months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic-assisted Latissimus Dorsi Tendon Transfer for the Management of Irreparable Rotator Cuff Tears in Middle-aged Physically Active Patients

Lim

Bae

2019

Clin Shoulder Elbow

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Background: Latissimus dorsi (LD) tendon transfer is used as a treatment option for massive irreparable posterosuperior rotator cuff tears, and recently, an arthroscopic-assisted technique was introduced. This study was undertaken to evaluate the clinical and radiological outcomes of arthroscopic-assisted LD tendon transfer for the management of irreparable rotator cuff tears in active middle-aged patients.Methods: The records of five patients (two males) with irreparable tears involving the supraspinatus and infraspinatus tendons managed by arthroscopic-assisted LD tendon transfer were retrospectively reviewed. Clinical outcomes were assessed using the visual analogue scale (VAS) pain scale, American Shoulder and Elbow Surgeon’s (ASES) scores, the University of California Los Angeles (UCLA) scale, and ranges of motion. Postoperative integrities of transferred tendon were evaluated by magnetic resonance imaging in 4 patients and by ultrasound in one.Results: Mean patient age was 55 years (range, 48?61 years), and mean follow-up period was 20 months (range, 12.0?27.2 months). Mean VAS score significantly improved from 6.6 ± 2.6 preoperatively to 1.8 ± 2.5 postoperatively (<i>p</i>=0.009), mean ASES score increased from 67.6 ± 9.2 to 84.6 ± 15.1, and mean UCLA score from 18.0 ± 1.4 to 28.8 ± 8.5 (all <i>p</i><0.001). Postoperative imaging of the transferred LD tendon showed intact repair in 4 patients. The remaining patient experienced LD transfer rupture and a poor outcome.Conclusions: Arthroscopic-assisted LD tendon transfer improved shoulder pain and function in patients with massive, irreparable rotator cuff tears, and may be an option for this condition, especially in physically active patients.

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Clinical and Radiographic Outcomes With Assessment of the Learning Curve in Arthroscopically Assisted Latissimus Dorsi Tendon Transfer for Irreparable Posterosuperior Rotator Cuff Tears

Cited by 25 publications

References 22 publications

Editorial Commentary: When the Shoulder Joint Has Lost Stoichiometry—Does Arthroscopic-Assisted Latissimus Dorsi Transfer Stack Up?

Editorial Commentary: When the Shoulder Joint Has Lost Stoichiometry—Does Arthroscopic-Assisted Latissimus Dorsi Transfer Stack Up?

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

Arthroscopic-assisted Latissimus Dorsi Tendon Transfer for the Management of Irreparable Rotator Cuff Tears in Middle-aged Physically Active Patients

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