Enhancement of External Rotation after Latissimus Dorsi Tendon Transfer (LDTT): A Cadaveric Study

Silberberg, Jose; Nilo, Alessandro; Roces-García, Jorge

doi:10.3390/medicina57040305

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Volunteers with no medical training ( n = 71): Subjects were recruited among the staff of a medical device distributing company (MBA SURGICAL EMPOWERMENT, Gijón, Spain), as performed by Silberberg et al [ 37 ]. Anybody who, on account of their position, had previous training in the field of hip surgery was excluded from participating in the study.…”

Section: Methodsmentioning

confidence: 99%

Orthopedic Surgeons’ Accuracy When Orienting an Acetabular Cup. A Comparison with Untrained Individuals

et al. 2022

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Background and Objectives: Previous studies demonstrated a huge variability among surgeons when it comes to reproducing the position of an acetabular cup in total hip arthroplasty. Our main objective is to determine if orthopedic surgeons can replicate a given orientation on a pelvic model better than untrained individuals. Our secondary objective is to determine if experience has any influence on their ability for this task. Materials and Methods: A group of specialist orthopedic hip surgeons and a group of volunteers with no medical training were asked to reproduce three given (randomly generated) acetabular cup orientations (inclination and anteversion) on a pelvic model. Error was measured by means of a hip navigation system and comparisons between groups were made using the appropriate statistical methods. Results: The study included 107 individuals, 36 orthopedic surgeons and 71 untrained volunteers. The mean error among surgeons was slightly greater as regards both inclination (7.84 ± 5.53 vs. 6.70 ± 4.03) and anteversion (5.85 ± 4.52 vs. 5.48 ± 3.44), although statistical significance was not reached (p = 0.226 and p = 0.639, respectively). Similarly, although surgeons with more than 100 procedures a year obtained better results than those with less surgical experience (8.01 vs. 7.67 degrees of error in inclination and 5.83 vs. 5.87 in anteversion), this difference was not statistically significant, either (p = 0.852 and p = 0.981). Conclusions: No differences were found in the average error made by orthopedic surgeons and untrained individuals. Furthermore, the surgeons’ cup orientation accuracy was not seen to improve significantly with experience.

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Section: Methodsmentioning

confidence: 99%

Orthopedic Surgeons’ Accuracy When Orienting an Acetabular Cup. A Comparison with Untrained Individuals

et al. 2022

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“…Among these, tendon transfers, initially studied for nerve injuries, are supported by biomechanical and clinical investigations describing their results in generally small to medium series (11)(12)(13)(14)(15)(16)(17)(18)(19). Transfer of the latissimus dorsi (LDT) on the greater tuberosity, at the level of the bicipital groove, transforms this muscle from an internal rotator to an external rotator (20,21). Some studies support that the transferred LD is actively part of the recovered shoulder function (14,22,23).…”

Section: Introductionmentioning

confidence: 99%

Association of Arthroscopically-Assisted Latissimus Dorsi Tendon Transfer with Implantation of a Subacromial Balloon Spacer for Patients with Irreparable Posterosuperior Rotator Cuff Tears

Gervasi¹,

Vigni²,

Vezeridis³

et al. 2022

Muscle Ligaments and Tendons J

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Purpose. Massive irreparable posterosuperior rotator cuff tears in an active population, resulting in a pseudo-paralytic shoulder, pose a challenge for the orthopaedic surgeon. In an effort to avoid or delay arthroplasty surgery, other surgical strategies such as arthroscopically-assisted latissimus dorsi transfer (aLDT) or the implantation of a subacromial spacer (SAS) can be considered. The aim of the present study is to associate, for the first time, these two surgical procedures in order to demonstrate the surgical feasibility and the effectiveness of their synergistic biomechanical effect. Methods. The study group consisted of patients who underwent aLDT for a massive irreparable posterosuperior rotator cuff tear with or without SAS placement. The study population consisted of 17 patients. Patients were assessed with the following outcomes scores: Constant and Murley Score (CMS), Disability of Arm, Shoulder and Hand (DASH), Oxford Shoulder Score (OSS), and Subjective Shoulder Value (SSV). Follow-up after surgery (T0) took place at the following time points: 40 days (T1), 3 months (T2), 9 months (T3), and 12 months (T4). Statistical analysis was performed by descriptive statistics, nonparametric ANOVA test, and a multivariate linear regression model. The effect of subscapularis repair on clinical outcomes was also examined with subgroup analysis. Results. In the entire population, the mean change in scores between T0 and T4 was: +30.5 for CMS, -35.14 for DASH, +18.06 for OSS, +40.47 for SSV. A statistically significant increase in all scores for both aLDT alone and aLDT with concomitant SAS was detected starting as early as T2. The subscapularis repair group had the following results as compared with the subscapularis intact group: CMS -9.5580 (p = 0.0164), OSS -5.6873 (p = 0.0378), and DASH +21.0424 (p = 0.0097). Conclusions. This study demonstrates, for the first time, the feasibility and efficacy of the arthroscopically-assisted latissimus dorsi transfer alone and with concomitant implantation of a subacromial spacer. Both surgeries demonstrate clinical efficacy as early as three months after surgery, with significant and progressive clinical improvements through 12 months postoperatively.

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Enhancement of External Rotation after Latissimus Dorsi Tendon Transfer (LDTT): A Cadaveric Study

Cited by 2 publications

References 29 publications

Orthopedic Surgeons’ Accuracy When Orienting an Acetabular Cup. A Comparison with Untrained Individuals

Orthopedic Surgeons’ Accuracy When Orienting an Acetabular Cup. A Comparison with Untrained Individuals

Association of Arthroscopically-Assisted Latissimus Dorsi Tendon Transfer with Implantation of a Subacromial Balloon Spacer for Patients with Irreparable Posterosuperior Rotator Cuff Tears

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