Latissimus Dorsi Tendon Transfer for Treatment of Irreparable Posterosuperior Rotator Cuff Tears

Gerber, Christian; Rahm, Stefan; Catanzaro, Sabrina; Farshad, Mazda; Moor, Beat K.

doi:10.2106/jbjs.m.00122

Cited by 264 publications

(244 citation statements)

References 29 publications

(46 reference statements)

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“…The most commonly utilized tendon transfer for failed rotator cuff repairs is the latissimus dorsi transfer. It can reliably and durably restore function, active range of motion, and strength and achieve pain relief in patients with irreparable posterosuperior rotator cuff tears [110][111][112][113]. However, poor results are often seen in patients with subscapularis insufficiency and teres minor fatty infiltration [110,111].…”

Section: Tendon Transfermentioning

confidence: 99%

“…Irreparable superior rotator cuff tears in patients that also have subscapularis insufficiency remain a difficult problem in patients that are not candidates for RSA. Because of the work of Gerber et al [110,111], we consider subscapularis insufficiency a contraindication to traditional latissimus transfer. A ventral latissimus transfer has been proposed and may be useful in this patient population [117], but there are currently no clinical outcomes reported in the literature to support the use of the procedure.…”

Section: Tendon Transfermentioning

confidence: 99%

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Management of complications after rotator cuff surgery

Parada

Dilisio

Kennedy

2014

Curr Rev Musculoskelet Med

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Rotator cuff repair (RCR) is a common procedure performed by orthopedic surgeons via arthroscopic, open, or mini-open techniques. While this surgery is considered to be of low morbidity, several potential complications can arise either intraoperatively or during the postoperative time period. Some of these complications are related to the surgical approach (arthroscopic or open), while others are patient dependent. Many of these complications can be managed through nonoperative means; however, early recognition and timely treatment is essential in limiting the long-term sequela and improving patient outcome. There are several different ways to classify complications after RCR repair: timing, severity, preventability, whether or not the pathology is intra-or extraarticular, and the type of treatment necessary. It is essential that the surgeon is cognizant of the etiology contributing to the failed RCR surgery in order to provide timely and proper management.

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Section: Tendon Transfermentioning

confidence: 99%

Section: Tendon Transfermentioning

confidence: 99%

Management of complications after rotator cuff surgery

Parada

Dilisio

Kennedy

2014

Curr Rev Musculoskelet Med

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“…We found a less-than-anticipated correlation between involvement of the teres minor and loss of active external rotation. These findings may have clinical relevance when planning reverse total shoulder replacements or tendon transfers for massive rotator cuff repairs as the teres minor has been shown to be important for successful outcomes of these procedures [10,22]. Furthermore, lack of teres minor function is a substantial functional disability, therefore the ability of the clinician to document this loss of function is important for advising patients on treatment options.…”

Section: Discussionmentioning

confidence: 94%

“…However, evidence suggests that its integrity may be one of the most important variables affecting the outcome of reverse shoulder arthroplasty for massive rotator cuff tears [10,22]. The functional effects on day-to-day activities can be important [4,18,20], and previous research [5] has shown that teres minor integrity affects the outcomes of tendon transfers in massive rotator cuff tears.…”

Section: Introductionmentioning

confidence: 99%

What is the Best Clinical Test for Assessment of the Teres Minor in Massive Rotator Cuff Tears?

Treseder

Denard

Neyton

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Few studies define the clinical signs to evaluate the integrity of teres minor in patients with massive rotator cuff tears. CT and MRI, with or without an arthrogram, can be limited by image quality, soft tissue density, motion artifact, and interobserver reliability. Additionally, the ill-defined junction between the infraspinatus and teres minor and the larger muscle-totendon ratio of the teres minor can contribute to error. Therefore, we wished to determine the validity of clinical testing for teres minor tears.Question/Purposes The aim of this study was to determine the accuracy of commonly used clinical signs (external rotation lag sign, drop sign, and the Patte test) for diagnosing the teres minor's integrity. Methods We performed a prospective evaluation of patients referred to our shoulder clinic for massive rotator cuff tears determined by CT arthrograms. The posterosuperior rotator cuff was examined clinically and correlated with CT arthrograms. We assessed interobserver reliability for CT assessment and used three different clinical tests of teres minor function (the external rotation lag sign, dropOne of the authors certifies that he (PC), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount less than USD 10,000 from Storz (Guyancourt, France), and an amount of USD 10,000-USD 100,000 from Tornier (Montbonnot, France). One of the authors certifies that he (GW), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of USD 100,001 to USD 1,000,000 from Tornier (Montbonnot, France). One of the authors certifies that he (PJD), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of USD 10,000 to USD 100,000 from Arthrex (Naples, FL, USA). One of the authors certifies that he (LN), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of USA 10,000 to USD 100,000 from Tornier (Montbonnet, France). 123Clin Orthop Relat Res (2015) 473:2959-2966 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® sign, and the Patte test). One hundred patients with a mean age of 68 years were available for the analysis. Results The most accurate test for teres minor dysfunction was an external rotation lag sign greater than 40°, which had a sensitivity of 100% (95% CI, 80%-100%) and a specificity of 92% (95% CI, 84%-96%). External rotation lag signs greater than 10°had a sensitivity of 100% (95% CI, 80%-100%) and a specificity of 51% (95% CI, 40%-61%). The Patte sign had a sensitivity of 93% (95% CI, 70%-99%) and a specificity of 72% (95% CI, 61%-80%). The drop sign had a sensitivity of 87% (95% CI, 62%-96%) and a specificity of 88% (95% CI, 80%-

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“…There was a slight but significant increase in osteoarthritic changes. Inferior results occurred in shoulders with insufficiency of the subscapularis muscle and fatty infiltration of the teres minor muscle [84].…”

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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Latissimus Dorsi Tendon Transfer for Treatment of Irreparable Posterosuperior Rotator Cuff Tears

Abstract: Therapeutic level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 264 publications

References 29 publications

Management of complications after rotator cuff surgery

Management of complications after rotator cuff surgery

What is the Best Clinical Test for Assessment of the Teres Minor in Massive Rotator Cuff Tears?

Options Before Reverse Total Shoulder Replacement

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