Mid- to long-term outcomes after reverse shoulder arthroplasty with latissimus dorsi and teres major transfer for irreparable posterosuperior rotator cuff tears

2021 ◽  
Author(s):  
Philippe Valenti ◽  
Leila Oryadi Zanjani ◽  
Bradley S. Schoch ◽  
Efi Kazum ◽  
Jean David Werthel
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Latissimus Dorsi ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Long Term Outcomes ◽  
Teres Major

Interposition GraftJacket allografts for irreparable rotator cuff tears

2022 ◽  
Vol 104-B (1) ◽  
pp. 91-96
Author(s):  
Amit Modi ◽  
Aziz Haque ◽  
Vijay Deore ◽  
Harvinder Pal Singh ◽  
Radhakant Pandey
Keyword(s):  
Rotator Cuff ◽  
Pain Score ◽  
Reverse Shoulder Arthroplasty ◽  
Young Patients ◽  
Rotator Cuff Tears ◽  
Long Term Outcomes ◽  
Open Reconstruction ◽  
One Year

Aims Long-term outcomes following the use of human dermal allografts in the treatment of symptomatic irreparable rotator cuff tears are not known. The aim of this study was to evaluate these outcomes, and to investigate whether this would be a good form of treatment in young patients in whom a reverse shoulder arthroplasty should ideally be avoided. Methods This prospective study included 47 shoulders in 45 patients who underwent an open reconstruction of the rotator cuff using an interposition GraftJacket allograft to bridge irreparable cuff tears, between January 2007 and November 2011. The Oxford Shoulder Score (OSS), pain score, and range of motion (ROM) were recorded preoperatively and at one year and a mean of 9.1 years (7.0 to 12.5) postoperatively. Results There was significant improvement in the mean OSS from 24.7 (SD 5.4) preoperatively to 42.0 (SD 6.3) at one year, and this improvement was maintained at 9.1 years (p < 0.001), with a score of 42.8 (SD 6.8). Similar significant improvements in the pain score were seen and maintained at the final follow-up from 6.1 (SD 1.6) to 2.1 (SD 2.3) (p < 0.001). There were also significant improvements in the ROM of the shoulder, and patient satisfaction was high. Conclusion The use of an interposition human dermal allograft in patients with an irreparable rotator cuff tear leads to good outcomes that are maintained at a mean of nine years postoperatively. Cite this article: Bone Joint J 2022;104-B(1):91–96.

Teres major tendon transfer in the treatment of irreparable posterosuperior rotator cuff tears

2018 ◽  
Vol 100-B (3) ◽  
pp. 309-317 ◽  
Author(s):  
A. Kolk ◽  
J. F. Henseler ◽  
F. J. Overes ◽  
J. Nagels ◽  
R. G. H. H. Nelissen
Keyword(s):  
Rotator Cuff ◽  
Latissimus Dorsi ◽  
Tendon Transfer ◽  
Rotator Cuff Tears ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Teres Major ◽  
Pain At Rest

Aims Since long-term outcome of teres major tendon transfer surgery for irreparable posterosuperior rotator cuff (RC) tears is largely unknown, the primary aim of this study was to evaluate the long-term outcome of the teres major transfer. We also aimed to report on the results of a cohort of patients with a similar indication for surgery that underwent a latissimus dorsi tendon transfer. Patients and Methods In this prospective cohort study, we reported on the long-term results of 20 consecutive patients with a teres major tendon transfer for irreparable massive posterosuperior RC tears. Additionally, we reported on the results of the latissimus dorsi tendon transfer (n = 19). The mean age was 60 years (47 to 77). Outcomes included the Constant score (CS), and pain at rest and during movement using the Visual Analogue Scale (VAS). Results At a mean of ten years (8 to 12) following teres major transfer, the CS was still 23 points (95% confidence interval (CI) 14.6 to 30.9, p < 0.001) higher than preoperatively. VAS for pain at rest (21 mm, 95% CI 4.0 to 38.9, p = 0.016) and movement (31 mm, 95% CI 16.0 to 45.1, p < 0.001) were lower than preoperatively. We also found an increase in CS (32 points, 95% CI 23.4 to 40.2, p < 0.001) and reduction of pain (26 mm, 95% CI 9.9 to 41.8, p = 0.001) six years after latissimus dorsi transfer. Conclusion Teres major tendon transfer is a treatment option to gain shoulder function and reduce pain in patients with an irreparable posterosuperior RC tear at a mean follow-up of ten years. The teres major tendon might be a valuable alternative to the commonly performed latissimus dorsi tendon transfer in the treatment of irreparable posterosuperior RC tears. Cite this article: Bone Joint J 2018;100-B:309–17.

scholarly journals Long-term outcome of arthroscopic debridement of massive irreparable rotator cuff tears

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241277
Author(s):  
Tim Vogler ◽  
Dimosthenis Andreou ◽  
Georg Gosheger ◽  
Nico Kurpiers ◽  
Clara Velmans ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Arthroscopic Debridement ◽  
Radiographic Outcome ◽  
Vas Score ◽  
Long Term Follow Up

Objectives To evaluate the clinical and radiographic outcome of low-demand patients with massive rotator cuff tears undergoing arthroscopic debridement in mid- and long-term follow-up, as well as the rate of conversion to reverse shoulder arthroplasty. Methods We performed a retrospective analysis of 19 patients with a mean age at surgery of 68 years (range, 55–80 years) from a previously described consecutive cohort and after a mean follow up of 47 month (FU1) and 145 month (FU2). The functional outcome was evaluated with the VAS score, the American Shoulder and Elbow Surgeons (ASES) score, and the age- and gender-adjusted Constant (aCS) score. The radiographic outcome was classified according to the Hamada classification. Non-parametric analyses were carried out with the Mann-Whitney U for independent samples and the Wilcoxon signed-rank test for related samples. Results Five patients (26%) developed symptomatic cuff tear arthropathy and underwent reverse shoulder arthroplasty after a mean time of 63 months (range, 45–97 months). These patients were excluded from further analyses. The mean VAS score of the remaining 14 patients at FU1 was significantly lower compared to preoperatively (P = .041), while there were no significant differences between the VAS score at FU1 and FU2 (P = 1.0). The ASES score of the affected shoulder at FU1 was significantly higher compared to prior to surgery (P = .028), while there were no significant differences between the scores of the affected shoulder between FU1 and FU2 (P = .878). While the ASES score of the contralateral shoulder at FU1 was significantly higher than the score of the affected shoulder (P = .038), there were no significant differences in the ASES scores of the affected and the healthy shoulder at FU2 (P = .575). The evaluation of the aCS produced similar results. A progression of the Hamada grade was documented in 6 patients. Conclusions Arthroscopic debridement is a safe and valid option for low-demand middle-age or elderly patients with symptomatic massive rotator cuff tears, leading to a significant pain relief and significantly improved functional outcome at mid- and long-term follow up. However, about a quarter of the patients in our cohort had to undergo reverse shoulder arthroplasty due to symptomatic cuff tear arthropathy. Furthermore, some of the remaining patients continued to undergo radiographic progression. This might be due to the natural history of their disease and/or the surgical procedure, and the clinical relevance of this finding should be evaluated in further studies.

scholarly journals Latissimus dorsi tendon transfers: a historical journey

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 9
Author(s):  
Ismail Turkmen ◽  
Emre Koraman ◽  
Oguz Poyanlı
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Latissimus Dorsi ◽  
Tendon Transfer ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Tendon Transfers ◽  
Technical Description

Several latissimus dorsi tendon transfer techniques for shoulder problems have been previously described and developed. These techniques involve the transfer in obstetric palsy, transfer in irreparable posterosuperior rotator cuff tears and subscapularis tears, and transfer in reverse shoulder arthroplasty. We detail the differences in planning and surgery and the need for different approaches. This historical and technical description provided in this study will benefit surgeons wishing to use the procedure.

Long-term outcomes of latissimus dorsi transfer for irreparable rotator cuff tears

2020 ◽  
Vol 44 (5) ◽  
pp. 905-910 ◽  
Author(s):  
Philippe Clavert ◽  
Joseph Arndt ◽  
Frédérique Daemgen ◽  
Jean-François Kempf
Keyword(s):  
Rotator Cuff ◽  
Latissimus Dorsi ◽  
Rotator Cuff Tears ◽  
Long Term Outcomes ◽  
Latissimus Dorsi Transfer

Reverse Shoulder Arthroplasty for Rotator Cuff Tears with and Without Prior Failed Repair: A Comparative Analysis

2021 ◽  
Vol 30 (7) ◽  
pp. e455
Author(s):  
Alexander J. Vervaecke ◽  
Andrew D. Carbone ◽  
Jashvant Poeran ◽  
Nicole Zubizarreta ◽  
Bradford O. Parsons ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Tears

scholarly journals Irreparable rotator cuff tears: Current treatment options

2019 ◽  
Vol 11 (3) ◽  
Author(s):  
Tristan Juhan ◽  
Michael Stone ◽  
Omid Jalali ◽  
Will Curtis ◽  
John Prodromo ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Reverse Shoulder Arthroplasty ◽  
Treatment Options ◽  
Current Treatment ◽  
Rotator Cuff Tears ◽  
Biceps Tenotomy ◽  
Common Causes ◽  
Cuff Repair ◽  
Term Data

Rotator cuff disease is one of the most common causes of shoulder pain, yet controversy still exists regarding treatment of “irreparable” tears. Nonoperative management, including physical therapy and steroid injections, should be reserved for those without significant pain or functional impairment. Debridement may be used for low-demand patients, and should be performed with partial cuff repair, subacromial decompression, and/or acromioplasty to maximize outcomes. Biceps tenotomy and/or tenodesis have been shown to reduce postoperative pain and improve satisfaction when performed in conjunction with rotator cuff repairs, with no difference in functional outcome comparatively. Tendon transfers have been advocated with the potential benefit to improve function and decrease pain. More recently, extracellular matrix and human-derived dermal allografts have been used off-label as patch grafts in irreparable tears. Superior capsular reconstructive techniques and subacromial balloon spacers serve a similar function by acting to depress the humeral head in a cuff-deficient shoulder, however long-term data is needed before widespread adoption of these procedures. Finally, reverse shoulder arthroplasty serves as a salvage option for low demand elderly patients.

Sign in / Sign up

Export Citation Format

Share Document