Modified latissimus dorsi and teres major transfer through a single delto-pectoral approach for external rotation deficit of the shoulder: As an isolated procedure or with a reverse arthroplasty

Boileau, Pascal; Chuinard, Christopher; Roussanne, Yannick; Neyton, Lionel; Trojani, Christophe

doi:10.1016/j.jse.2007.02.127

Cited by 183 publications

(135 citation statements)

References 59 publications

(87 reference statements)

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“…Similar results were reported in seven cases of external rotation deficits resulting from posterosuperior cuff tears [3]. After a minimum followup of 15 months (mean, 22 months; range, 15-41 months), shoulder function and motion increased significantly in all cases with a gain of absolute Constant and Murley score of approximately 32 points.…”

Section: Discussionsupporting

confidence: 84%

“…The increase in postoperative shoulder function in these patients is similar to the results of other published studies in which the L'Episcopo procedure was used for treatment of brachial plexus injuries, posterosuperior cuff tears, and after latissimus dorsi transfer [2,3]. Beauchamp et al described the results of 11 patients undergoing the L'Episcopo procedure resulting from adult-onset brachial plexus injuries with deficient external rotation [2].…”

Section: Discussionsupporting

confidence: 79%

“…Taking this marginal gain of external rotation into account, some authors argued combined transfer of latissimus dorsi and teres major tendons might lead to increased restoration of active external rotation resulting from a more powerful transfer [3,14]. This difference in external rotation might not be permanent as seen with the loss of external rotation between 2 and 5 years in our patients.…”

Section: Discussionmentioning

confidence: 70%

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Modified L'Episcopo Tendon Transfers for Irreparable Rotator Cuff Tears: 5-year Followup

Gerhardt

Lehmann

Lichtenberg³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Patients with posterosuperior cuff tears lose functional external rotation of the shoulder. Latissimus dorsi and teres major transfer is performed to restore external rotation. Twenty patients with a mean age was 55.8 ± 6 years underwent this procedure and were examined at averages of 24.7 (n = 17) and 70.6 (n = 13) months. Two patients did not improve presumably because of failure of the transfer. The Constant and Murley score increased from 55.6 to 90.4 after 2 years and to 87.9 after 5 years. The mean active flexion increased from 119.4°to 169.3°and reached 170°after 5 years, and mean external rotation increased from 12°to 35°, finally reaching 23°.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 70%

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Modified L'Episcopo Tendon Transfers for Irreparable Rotator Cuff Tears: 5-year Followup

Gerhardt

Lehmann

Lichtenberg³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…The indications for RTSA have expanded over the last few years and include CTA [15,18,26,50,57,61], inflammatory arthropathy with massive rotator cuff tear [26,45], proximal humeral nonunion or malunion [6,34,57], acute fractures [34,57,58], fixed glenohumeral dislocation [57], posttraumatic arthritis [26,57], tumor [4,13,35,57], revision arthroplasty [6,27,33,57], and chronic pseudoparalysis without arthritis [41,57,60,61]. We will limit our discussion to problems dealing with the rotator cuff.…”

Section: Indications For Reverse Total Shoulder Arthroplastymentioning

confidence: 99%

“…The RTSA was originally designed to treat a massive irreparable rotator cuff with superior migration of the humeral head combined with glenohumeral arthritis (cuff tear arthropathy [CTA]) [5,15,18,21,40]. The indications have expanded however, and currently it is being used for multiple diagnoses including fracture sequelae [6,31,32,34,58], revision arthroplasty [6,27,33,57], instability [57], and tumors [4,13,35,57]. As a result of its success with these problems, its indications are gradually increasing, and many are unsure about its role in the treatment of rotator cuff disease.…”

Section: Introductionmentioning

confidence: 99%

Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Drake¹,

O’Connor

Edwards

2010

Clinical Orthopaedics &Amp; Related Research

206

124

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Background Reverse total shoulder arthroplasty (RTSA) was introduced to treat rotator cuff tear arthropathy but is now used to treat a variety of problems. Although its use has expanded substantially since the FDA's approval in 2004, the appropriateness in patients with rotator cuff disease is unclear. Questions/purposes We review the use of RTSA in patients with rotator cuff disease to (1) describe classification of rotator cuff tear reparability and the concept of a balanced shoulder; (2) explore the theory behind RTSA design relative to rotator cuff arthropathy; (3) discuss the indications and contraindications for RTSA; and (4) review published outcomes of RTSA for rotator cuff arthropathy.Methods We performed a selective review of the literature on the use of RTSA in the treatment of rotator cuff disease.Results Modern RTSA designs restore deltoid tension and a functional fulcrum to the rotator cuff deficient shoulder, which allows recovery of active shoulder elevation and effectively restores function in short-and mediumterm followup studies. Conclusions In short-term followup the RTSA relieves symptoms and restores function for patients with cuff tear arthropathy and irreparable rotator cuff tears with pseudoparalysis (preserved deltoid contraction but loss of active elevation). Severely impaired deltoid function, an isolated supraspinatus tear, and the presence of full active shoulder elevation with a massive rotator cuff tear and arthritis are contraindications to RTSA. Clinical Relevance For properly selected patients who have symptomatic and disabling rotator cuff deficiency, RTSA can result in life-changing improvements in pain, motion, function, and patient satisfaction. Level of Evidence Level V therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Reverse total shoulder arthroplasty

Sánchez-Sotelo

2008

Clinical Anatomy

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Reverse total shoulder arthroplasty designs have gained popularity over the last few years due to their satisfactory functional results in patients with cuff-tear arthropathy and other difficult reconstructive shoulder problems. These semiconstrained prostheses improve stability and active elevation in the absence of a functional rotator cuff by coupling a spherical glenoid component with a concave humeral component and increasing deltoid tension. Understanding the anatomy of the shoulder is critical in order to ensure secure fixation of the glenoid component, explore uncemented options for humeral component fixation, and determine the ideal soft-tissue tension to provide the best functional outcome without increasing the risk of complications. Key anatomic elements to be considered for the successful implantation of a reverse prosthesis include the orientation and size of the glenoid vault, the scapular regions with better bone stock (coracoid, spine of the scapula), the internal geometry of the humeral medullary canal, and the effects of reverse arthroplasty on the deltoid and brachial plexus.

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Modified latissimus dorsi and teres major transfer through a single delto-pectoral approach for external rotation deficit of the shoulder: As an isolated procedure or with a reverse arthroplasty

Cited by 183 publications

References 59 publications

Modified L'Episcopo Tendon Transfers for Irreparable Rotator Cuff Tears: 5-year Followup

Modified L'Episcopo Tendon Transfers for Irreparable Rotator Cuff Tears: 5-year Followup

Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Reverse total shoulder arthroplasty

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