Influence of fixation point of latissimus dorsi tendon transfer for irreparable rotator cuff tear on glenohumeral external rotation: A cadaver study

Background and objectives: Massive rotator cuff tears compromise shoulder mobility function and cannot be directly repaired. Latissimus dorsi tendon transfer (LDTT) is a therapeutic alternative suitable for the treatment of rotator cuff tears that helps to restore external shoulder rotation. Cadaver models have been used for studying the effects of LDTT and procedural variations, but, to the best of our knowledge, none of them have been validated. The aim of our study was to validate a novel cadaver model while verifying the effects of LDTT on external rotation. Materials and Methods: Two groups were included in the study: a cadaver group and a control group made up of healthy volunteers, which were used for the validation of the cadaver model. Baseline external rotation measurements were performed with both groups, after which a massive rotator cuff tear was inflicted and repaired with LDTT in the cadaver group. Their postoperative external rotation was evaluated using three different tests. Results: No statistically significant differences were found between the baseline measurements of the two groups, and postoperative external rotation was significantly higher after LDTT in all cases but one. Conclusions: Cadaver models were validated, since they had a similar preoperative external rotation to healthy volunteers. Moreover, they allowed us to demonstrate the effect of LDTT on external shoulder rotation.

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Reverse Shoulder Arthroplasty with Tendon Transfer Using Single Incision for Massive Rotator Cuff Tear with Loss of External Rotation

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2012.47.3.236 ◽

2012 ◽

Vol 47 (3) ◽

pp. 236 ◽

Cited By ~ 1

Author(s):

Bong Gun Lee ◽

Jeong Han Oh ◽

Youn Ho Choi ◽

Yong Girl Rhee

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Shoulder Arthroplasty ◽

Tendon Transfer ◽

Single Incision ◽

External Rotation ◽

Reverse Shoulder Arthroplasty ◽

Massive Rotator Cuff Tear ◽

Cuff Tear

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Description of Surgery Technique of the Lower Trapezius Transfer with Semitendinosus and Gracilis Tendon Graft for the Treatment of Massive or Irreparable Rotator Cuff Tear

10.21203/rs.3.rs-100324/v1 ◽

2020 ◽

Author(s):

Thiago Bernardo Carvallho de Almeida ◽

Luciano Miller Reis Rodrigues ◽

Marcel Jun Sugawara Tamaoki ◽

Luciano Pascarelli ◽

Roberto Rangel Bongiovanni

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

External Rotation ◽

Low Cost ◽

Hamstring Tendon ◽

Greater Tuberosity ◽

Cuff Tear ◽

Surgery Technique ◽

Lower Trapezius ◽

Irreparable Rotator Cuff Tear

Abstract Background: The current work describes a surgery technique where the autograft of hamstring tendon (semitendinosus and gracilis) was used as adjuvant in the transfer of the lower trapezius for the treatment of massive or irreparable rotator cuff tear. There is a theoretical advantage that the graft takes a greater footprint area in the greater tuberosity of the humerus corresponding to the infraspinatus, thus recreating the native anatomy more accurately.Methods: The autograft of hamstring tendon was attached to the lower trapezius through an incision of 4cm in the middle third of the scapular spine and transferred to the footprint of the infraspinatus in the greater tuberosity of the humerus, where it is attached through the second incision under the lateral acromial margin.Result: The patient was examined preoperatively and after 6 months of follow-up, and his pain, according to the Visual Analogue Scale, varied from 8 to 3, the range of motion improved in abduction from 100° to 120°, external rotation from 30° to 50° and flexion from 110° to 150°. The Shoulder Subjective Value ranged between 60 and 80% and the Disabilities of the Arm, Shoulder and Hand score went from 45 to 18.3.Conclusions: The lower trapezius transfer with autograft of hamstring tendons is a low-cost and relatively reproducible surgical technique with theoretical biomechanical and anatomic advantages that may bring about better function results.

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