Enhancement of External Rotation after Latissimus Dorsi Tendon Transfer (LDTT): A Cadaveric 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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Does the latissimus dorsi tendon transfer for massive rotator cuff tears remain active postoperatively and restore active external rotation?

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2013.07.055 ◽

2014 ◽

Vol 23 (4) ◽

pp. 553-560 ◽

Cited By ~ 37

Author(s):

Jan Ferdinand Henseler ◽

Jochem Nagels ◽

Rob G.H.H. Nelissen ◽

Jurriaan H. de Groot

Keyword(s):

Rotator Cuff ◽

Latissimus Dorsi ◽

Tendon Transfer ◽

External Rotation ◽

Rotator Cuff Tears ◽

Massive Rotator Cuff Tears

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Muscle Activity of the Latissimus Dorsi after Tendon Transfer in Patients with Rotator Cuff Tears

Journal of Clinical Medicine ◽

10.3390/jcm9020433 ◽

2020 ◽

Vol 9 (2) ◽

pp. 433 ◽

Cited By ~ 1

Author(s):

Pit Hetto ◽

David Spranz ◽

Felix Zeifang ◽

Sebastian I. Wolf ◽

Stefan van Drongelen ◽

...

Keyword(s):

Rotator Cuff ◽

Latissimus Dorsi ◽

Tendon Transfer ◽

Daily Life ◽

External Rotation ◽

Rotator Cuff Tears ◽

Emg Activity ◽

Measurement Protocol ◽

Partial Activity ◽

Perineal Care

Background: Massive irreparable posterosuperior rotator cuff tears may result in the loss of external rotation. Most of the patients with posterosuperior rotator cuff tears suffer from a restriction in their daily life actions. Latissimus dorsi tendon transfer (LDTT) is a method to restore abduction and external rotation in these patients. However, the behavior of the LD after the transfer is not clear yet. Few studies have analyzed the activity of the LD after transfer. The goal of this study was to examine the function of the LD postoperatively in follow-up examinations during activities of daily life (ADLs) and during different movements evaluated by measuring the range of motion (ROM). Methods: We examined 12 patients 4.3 years (1–9 years) after LDTT, using simultaneous 3D motion analysis and surface Electromyography (sEMG) of 12 muscle parts; the opposite, nonaffected side was assessed as a control. The measurement protocol included two standardized movements (exorotation with an adducted arm and exorotation with 90° abduction) as well as two ADLs (combing hair and perineal care). Results: An average of 4.3 years (1–9 years) after LDTT, 9 of the 12 subjects showed EMG activity in the transferred LD during glenohumeral external rotation. During the endorotation phase, either little activity was registered or only the pectoralis major was active. During the ADLs, 6 out of 12 subjects showed EMG activity in the transferred LD while “combing hair”, whereas all subjects showed EMG activity during perineal care. Conclusion: The LD showed partial activity in its new role as an exorotator, but no clear difference was observed between some of the movements as well as in comparison with the healthy shoulder. Further studies will need to be conducted to better differentiate voluntary contractions and co-contractions as well as tension and extension in the muscle.

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

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2016.09.012 ◽

2016 ◽

Vol 102 (8) ◽

pp. 971-975 ◽

Cited By ~ 6

Author(s):

K. Bargoin ◽

M. Boissard ◽

J. Kany ◽

J. Grimberg

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Latissimus Dorsi ◽

Tendon Transfer ◽

External Rotation ◽

Cadaver Study ◽

Cuff Tear ◽

Irreparable Rotator Cuff Tear

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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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Latissimus Dorsi Tendon Transfer for Irreparable Rotator Cuff Tears: A Modified Technique to Improve Tendon Transfer Integrity: Surgical Technique

Yearbook of Hand and Upper Limb Surgery ◽

10.1016/j.yhls.2011.05.005 ◽

2011 ◽

Vol 2011 ◽

pp. 202-203

Author(s):

T. Duquin

Keyword(s):

Rotator Cuff ◽

Surgical Technique ◽

Latissimus Dorsi ◽

Tendon Transfer ◽

Rotator Cuff Tears ◽

Modified Technique

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DOES HYPERCHOLESTOLEMIA PREDISPOSE TO ROTATOR CUFF PATHOLOGIES?

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i4.16883 ◽

2017 ◽

Vol 10 (4) ◽

pp. 373 ◽

Cited By ~ 1

Author(s):

Surendra Umesh Kamath ◽

Sunil Murthy

Keyword(s):

Rotator Cuff ◽

Total Cholesterol ◽

Rotator Cuff Tear ◽

Indian Population ◽

Statistical Significance ◽

Elevated Serum ◽

Density Lipoprotein ◽

Rotator Cuff Tears ◽

Control Group ◽

Cuff Tear

Background: Rotator cuff tear are one of most common orthopedic musculoskeletal problem gaining importance due to large health scale expenditure. Causes of rotator cuff tears are multifactorial and unclear. Previous studies have suggested relation between elevated serum lipid profile and rotator cuff tear in western population. We therefore undertook study in our Indian population to correlate association of hypercholesterolemia with rotator cuff tear.Objective: To find association of rotator cuff pathology with hypercholesterolemia in Indian patients.Materials and methods: After obtaining clearance from institutional ethics committee. We prospectively collected fasting lipid samples of population who came to our hospitals with complaints of shoulder pain during our study period. 50 patients had rupture of rotator cuff which was confirmed by ultrasound of involved shoulder. 50 were seen for non-cuff related complaints. We followed strict inclusion and exclusion criteria.Results: Total cholesterol, Triglycerides and low density lipoprotein concentration of patients with rotator cuff tendon tear were on higher side than control group. High density lipoprotein trend showed being lower than control group. 21 of 50 (42%) had high cholesterol (total cholesterol greater than 240mg/dl) than compared to 18 of 50 (36%) in control group. however P value=0.539 and showed no statistical significance between groups.Conclusion: In Indian population there was no correlation between hypercholesterolemia and rotator cuff tear which is statistically significant.Key words Rotator cuff tear, Hypercholesterolemia, Indian population.

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