Superior capsular reconstruction (SCR) demonstrated its efficacy as a treatment option available in patients affected with irreparable posterosuperior rotator cuff tears without any signs of arthritis. Originally, the fascia lata autograft was fixed medially to the glenoid (with two or more anchors) and laterally to the greater tuberosity (with a compression double-row technique using four anchors or three transosseous tunnels). Additionally, side-to-side sutures were used to anteriorly and posteriorly connect the graft to the native residual rotator cuff tissue. However, the fascia lata as an autograft has a disadvantage related to the donor-site morbidity. To solve this aspect, allografts were employed with initial promising results. Nowadays, SCR is to be considered a technically demanding and expensive procedure, because of the cost of the allograft plus that of all the anchors employed to fix it. The Arthroscopic Biceps Chillemi's technique addresses these concerns in performing SCR and presents numerous advantages being a safe, easier, time and cost-saving way compared to the other published techniques. This technique has only one conditio sine qua non: the presence of the long head of the biceps tendon (LHB), used as an autograft. This condition may be interpreted as a disadvantage of this procedure in the presence of some anatomic variations of the intra-articular portion of the LHB and the very rare absence of the tendon or in case of partial or complete rupture of the LHB tendon associated with a rotator cuff tear.

Purpose Latissimus dorsi tendon transfer is a surgical option for the treatment of massive irreparable posterosuperior rotator cuff tear. Whether a favourable clinical outcome is due to the latissimus dorsi muscle contraction rather than the passive tenodesis effect remains to be confirmed. The purpose of the current case–control study was to evaluate the shoulder kinematics and latissimus dorsi activation after latissimus dorsi tendon transfer. Methods Eighteen patients suffering from irreparable rotator cuff tear that underwent latissimus dorsi tendon transfer and 18 healthy individuals were examined using a 3D kinematic tracking system and electromyography. Active maximal flexion–extension and abduction–adduction of the humerus were measured for the operated and the contralateral shoulder of the patients and the shoulder of healthy individuals to evaluate the range of motion (ROM) and scapulohumeral rhythm. Electromyographic comparison of isometric contraction between the latissimus dorsi of the operated and contralateral shoulder was carried out. Results After arthroscopic‐assisted latissimus dorsi tendon transfer, patients showed comparable flexion and abduction ROM to their asymptomatic contralateral shoulders and to the shoulders of healthy individuals. Significantly higher scapular ROM values were found between the latissimus dorsi tendon transfer side and the shoulders of healthy individuals. While performing external rotation with 0° shoulder abduction, a greater percentage of the electromyographic peak value (p = 0.047) and a higher latissimus dorsi internal/external rotation ratio (p = 0.004) were noted for the transferred muscle in comparison to the contralateral shoulder. Conclusion Although the arthroscopic‐assisted latissimus dorsi tendon transfer failed to normalize scapulothoracic joint movements of patients, a functional latissimus flap and a shoulder ROM similar to the contralateral side or the shoulder of healthy individuals can be expected after this procedure in patients with massive irreparable posterosuperior rotator cuff tear. Level of evidence III.

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Purpose: To evaluate the intra and interobserver reproducibility of a new system that assesses the threedimensional humero-scapulo-thoracic kinematics using wearable technology in an outpatient setting. To obtain normative data with the system for scapular angular motions in three planes. Methods: The SHoW Motion 3D kinematic tracking system is a motion analysis system that uses wireless wearable non-invasive inertial-magnetic sensors to assess the three-dimensional kinematics of the shoulder girdle. The sensors are placed over the skin in the sternum, scapular spine and arm to precisely define angular motions of the humerus and the scapula with three Degrees of Freedom (DOF) for each segment. The system was used to measure the scapular angular motions in three planes (upward/downward rotation, internal/external rotation and anterior/posterior tilt) during two shoulder full-range movements (flexion/extension and abduction/abduction) in both shoulders of 25 healthy volunteers (13 males and 12 females, mean age: 37 [standard deviation 11.1] years). In a first measuring session one examiner made two evaluations alternating with another examiner that made a third evaluation. In a second session, one week apart, the first examiner made a fourth evaluation. A mean curve was computed from the normalized data for each measurement to obtain normative data for scapular angular kinematics. Intra and inter-observer reproducibility was evaluated using Root Mean Square Error Estimation (RMSE) and Coefficients for Multiple Correlations (CMC). Results: Both shoulders of the 25 volunteers were evaluated four times. The two hundred resulting kinematic analyses were pooled to get normative values for relations between humeral elevation angles and the three angular movements of the scapula. The system showed at least very good (CMC > 0.90) intra and inter-observer reproducibility for scapular tilt and upward-downward rotations both in flexion and abduction. For scapular internal-external rotation the results were

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