Latissimus dorsi muscle transfer reduces external rotation deficit at the cost of internal rotation in reverse shoulder arthroplasty patients: a cohort study

Background The purpose of this biomechanical simulator study was primarily to compare latissimus dorsi to lower trapezius tendon transfers for active external rotation and the pectoralis major transfer for internal rotation after reverse shoulder arthroplasty. Secondarily, the role of humeral component lateralization on transfer function was assessed. Methods Eight rotator cuff deficient cadavers underwent reverse shoulder arthroplasty with an adjustable lateralization humeral component. Latissimus dorsi and lower trapezius transfers were compared for active external rotation restoration and pectoralis major transfer for internal rotation restoration. Internal rotation/external rotation torques were measured for each lateralization at varying abduction and internal rotation/external rotation ranges-of-motion. Results The lower trapezius transfer generated, on average, 1.6 ± 0.2 nm more torque than the latissimus dorsi transfer (p < 0.001). The internal rotation/external rotation torques of all tendon transfers decreased as abduction increased (p < 0.01). At 0° elevation, reverse shoulder arthroplasty humeral component lateralization had a significant positive effect on tendon transfer torque at 60° internal rotation and external rotation (p < 0.01). Discussion Both the lower trapezius and the latissimus dorsi tendon transfers were effective in restoring active external rotation after reverse shoulder arthroplasty; however, the lower trapezius generated significantly more torque. Additionally, the pectoralis major transfer was effective in restoring active internal rotation. All tendon transfers were optimized with greater humeral component lateralization.

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Reverse shoulder arthroplasty combined with a latissimus dorsi and teres major transfer for a deficit of both active elevation and external rotation. Results of 15 cases with a minimum of 2-year follow-up

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2012.11.014 ◽

2013 ◽

Vol 99 (2) ◽

pp. 131-137 ◽

Cited By ~ 35

Author(s):

O. Boughebri ◽

A. Kilinc ◽

P. Valenti

Keyword(s):

Shoulder Arthroplasty ◽

Latissimus Dorsi ◽

External Rotation ◽

Reverse Shoulder Arthroplasty ◽

Teres Major

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Functional Sphincter Ani Externus Reconstruction for Treatment of Fecal Stress Incontinence Using Free Latissimus Dorsi Muscle Transfer with Coaptation to the Pudendal Nerve: Preliminary Experimental Study in Dogs

Journal of Reconstructive Microsurgery ◽

10.1055/s-2007-970187 ◽

2007 ◽

Vol 23 (2) ◽

pp. 079-085 ◽

Cited By ~ 5

Author(s):

Anton Schwabegger ◽

Peter Kronberger ◽

Peter Obrist ◽

Endre Brath ◽

Iren Miko

Keyword(s):

Experimental Study ◽

Stress Incontinence ◽

Latissimus Dorsi ◽

Pudendal Nerve ◽

Latissimus Dorsi Muscle ◽

Muscle Transfer ◽

Dorsi Muscle

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Glenosphere design affects range of movement and risk of friction-type scapular impingement in reverse shoulder arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.100b9.bjj-2018-0264.r1 ◽

2018 ◽

Vol 100-B (9) ◽

pp. 1182-1186 ◽

Cited By ~ 21

Author(s):

B. S. Werner ◽

J. Chaoui ◽

G. Walch

Keyword(s):

Internal Rotation ◽

Shoulder Arthroplasty ◽

External Rotation ◽

Reverse Shoulder Arthroplasty ◽

Large Diameter ◽

Glenoid Component ◽

Range Of Movement ◽

Scapular Notching ◽

Component Size ◽

Centre Of Rotation

Aims Scapular notching is a frequently observed radiographic phenomenon in reverse shoulder arthroplasty (RSA), signifying impingement of components. The purposes of this study were to evaluate the effect of glenoid component size and glenosphere type on impingement-free range of movement (ROM) for extension and internal and external rotation in a virtual RSA model, and to determine the optimal configuration to reduce the incidence of friction-type scapular notching. Materials and Methods Preoperative CT scans obtained in 21 patients (three male, 18 female) with primary osteoarthritis were analyzed using modelling software. Two concurrent factors were tested for impingement-free ROM and translation of the centre of rotation: glenosphere diameter (36 mm vs 39 mm) and type (centred, 2 mm inferior eccentric offset, 10° inferior tilt). Results Glenosphere size was most predictive of increased extension and external rotation, whereas lateralization of the centre of rotation was the most predictive factor for internal rotation. A larger diameter of glenosphere combined with a 10° tilted configuration demonstrated superior values for extension and external rotation, whereas the eccentric component improved internal rotation by a mean 8.9° (standard deviation 2.7°) compared with a standard concentric glenosphere. Conclusion Glenosphere configuration can be modified to increase range of movement in RSA. Friction-type scapular notching was most effectively reduced by use of a large-diameter glenosphere with 10° inferior tilt. Cite this article: Bone Joint J 2018;100-B:1182–6.

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