Comparison of arthroscopically assisted transfer of the latissimus dorsi with or without partial cuff repair for irreparable postero-superior rotator cuff tear

Valenti, Philippe; Reinares, Felipe; Maroun, Charbel; Choueiry, James; Werthel, Jean‐David

doi:10.1007/s00264-018-4016-6

Cited by 13 publications

(11 citation statements)

References 28 publications

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“…[33] In an observational study conducted 10 years after surgery, the results showed that LDT has a good function in the treatment of IRCTs. [34] A review of the literature found that for patients with IRCTs, active flexion of the shoulder joint before tendon transposition > 120° had better postoperative results, [31] and patients with preoperative SSV scores <40 points had poor postoperative function, [35] which indicates that LDT may be more effective for patients with better shoulder joint function.…”

Section: Discussionmentioning

confidence: 99%

Multiple surgical treatment comparisons for irreparable rotator cuff tears: A network meta-analysis

et al. 2023

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Background: To evaluate the effect of different surgical methods in the treatment of patients with irreparable rotator cuff tears (IRCTs) using a network meta-analysis. Methods: A search of the PubMed, EMbase, The Cochrane Library, VIP, WanFang Data, and CNKI databases was performed in January 2023 to search for randomized controlled trials and cohort studies of different surgical methods in the treatment of IRCTs. Risk assessment of the included randomized controlled trials was conducted using the risk of bias assessment tool recommended by the Cochrane Manual, and the Newcastle-Ottawa Scale was used for the risk assessment of cohort studies. Data were analyzed and plotted using Stata 15.0 software. Results: A total of 17 studies involving 2123 patients and 10 surgical methods were included in this study. According to the surface under the cumulative ranking curve, the probability ranking in descending order is latissimus dorsi transfer (LDT) + partial repair > LDT > reverse total shoulder arthroplasty > superior capsular reconstruction > patch > partial repair > debridement + tenotomy of the long head of the biceps > debridement > in space subacromial balloon spacer + tenotomy of the long head of the biceps > in space subacromial balloon spacer. Conclusion: Among the multiple surgical treatments for patients with IRCTs, LDT + partial repair may have the best effect, and more randomized controlled trials with larger sample sizes are needed for further verification.

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Section: Discussionmentioning

confidence: 99%

Multiple surgical treatment comparisons for irreparable rotator cuff tears: A network meta-analysis

et al. 2023

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“…However, with the re-tear rates of massive rotator cuff tears ranging from 20 to 94% [7,34,46,49], many are considered functionally irreparable rotator cuff tears (FIRCT). The treatment options for a patient with a FIRCT include partial repair [9,17,26,58,91], augmentation or bridging with allografts [4,18,33,62,82,94], superior capsular reconstruction [3,6,22,25,27,51,61,63,65,67,81,84,102], subacromial balloon [90], latissimus dorsi tendon transfer [1, 8, 10, 13, 15, 19, 20, 23, 24, 28, 32, 36, 38, 39, 41, 44, 45, 50, 52, 54-56, 64, 71, 74, 76, 80, 83, 86, 87, 95, 98, 99, 103, 104], lower trapezius tendon transfer [30,31,95,97], and reverse shoulder arthroplasty [11,43,48,77]. Given that the results of partial repair [91] deteriorate with time and the reverse shoulder arthroplasty has been associated with complications [48,96] and functional limitations [2,…”

Section: Discussionmentioning

confidence: 99%

“…In total, we included 46 papers with 1,287 procedures performed in this systematic review. We compared SCRs performed with either a dermal allograft (SCR-Allo, n = 253) [3,25,27,51,61,84,100] or TFL autograft (SCR-TFL, n = 160) [6,22,63,65,67,81] with the LDT performed via the open Gerber (oLDTG, n = 445) [1,8,19,20,24,28,36,38,39,45,50,52,54,71,74,76,80,87,98,99,104] technique, the open L'Episcopo (oLDTL, n = 60) [10,32,41,64,74] technique, or the arthroscopic-assisted technique (aLDT, n = 369) [13,15,23,44,55,56,83,86,9...…”

Section: Tablementioning

confidence: 99%

“…However, some studies have shown difficulty for the patients retraining their transferred tendon [53] and associated poor long-term outcomes [75]. In recent years, the technique has been modified to be performed in an arthroscopic-assisted fashion, avoiding the need to potentially compromise the deltoid through a deltoid split or acromial osteotomy [13,15,23,44,55,56,83,86,94,103]. In our review, although in theory the arthroscopicassisted approach would improve clinical outcomes, it does not appear to show a difference so far in the literature, with similar clinical improvements with both techniques.…”

Section: Tablementioning

confidence: 99%

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Clinical outcomes of latissimus dorsi tendon transfer and superior capsular reconstruction for irreparable rotator cuff tears: a systematic review

Broida

Sweeney

Gottschalk

et al. 2021

Eur J Orthop Surg Traumatol

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Background Functionally irreparable rotator cuff tears (FIRCTs) present an ongoing challenge to the orthopedic surgeon. The aim of this systematic review was to critically compare the outcomes of three latissimus dorsi tendon transfer (LDT) techniques and two superior capsular reconstruction (SCR) techniques in treatment of FIRCTs. Methods A systematic review of studies evaluating the outcome of FIRCT treatment was performed via a search of four databases in April 2020. Each included study was reviewed in duplicate by two reviewers for evaluation of methodological quality. The treatments analyzed were arthroscopic LDT (aLDT), open LDT Gerber technique (oLDTG), open LDT L'Episcopo technique (oLDTL), SCR with allograft (SCR-Allo), and SCR with autograft (SCR-TFL). Demographics, range of motion, patient-reported outcome measures, radiographic acromiohumeral distance (AHD), treatment failures, and revisions were recorded. Results Forty-six studies (1287 shoulders) met criteria for inclusion. Twenty-three studies involved open latissimus transfer, with 445 shoulders undergoing oLDTG with mean follow-up of 63.2 months and 60 patients undergoing oLDTL with mean follow-up of 51.8 months. Ten studies (n = 369, F/U 29.2mo) reported on aLDT. Seven studies (n = 253, F/U 16.9mo) concerned SCR-Allo, and six studies (n = 160, F/U 32.mo) reported on SCR-TFL. Range of motion and subjective outcome scores improved in all techniques with no differences across treatments. Both SCR methods provided greater improvement in AHD than open LDT methods (p < 0.01). The re-tear rates were lower in both oLDT groups compared to the SCR groups (p = 0.03). Clinical failure rates were higher in the SCR-Allo and oLDTG groups, while overall treatment failures were lowest in oLDTL compared to all four other groups. Conclusion SCR techniques were associated with improved short-term radiographic acromiohumeral distance, while the open LDT techniques had lower tendon re-tear and treatment failure rates. All techniques resulted in improved clinical outcomes and pain relief compared to preoperative levels with no differences across techniques. Level of evidence IV Systematic review of case series and cohort studies.

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“…Irreparable tears can be also defined as stage 3 tendon retraction according to Patte, stage 3 or 4 fatty infiltration as described by Goutallier et al, stage 3 muscle atrophy according to Thomazeau et al, or superior escape of the humeral head with a subacromial distance <6 mm, Hamada stage 3 with acetabulization of the acromion, failed previous cuff repair, or inability to anatomically repair the cuff after full arthroscopic release. [2][3][4][5] Pseudo-paralytic shoulder was redefined by Burks et al 2,6 as the association of a normal passive range of motion (no stiffness) with no active forward flexion (FF; <45 ) or limited active external rotation and/or internal rotation. 2 Many treatment options have been proposed to manage irreparable RCT including debridement with subacromial bursectomy 7 and/or tenotomy or tenodesis of the long head of the biceps, 8,9 partial repair of the residual cuff, 10 deltoid flap, 11 lower trapezius transfer, 12 latissimus dorsi (LD) transfer, 13 reverse shoulder arthroplasty, 14 and the interposition of a subacromial spacer 15 or superior capsule reconstruction.…”

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confidence: 99%

Combined Fully Arthroscopic Transfer of Latissimus Dorsi and Teres Major for Treatment of Irreparable Posterosuperior Rotator Cuff Tears

Kany

Selim

2020

Arthroscopy Techniques

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Many treatment options have been proposed for treatment of irreparable posterosuperior rotator cuff tears. Among these options, latissimus dorsi tendon transfer can be considered a good alternative, especially in young patients before development of glenohumeral arthritic changes, aiming at rebalancing the shoulder with a functioning subscapularis muscle and restoring both active external rotation and elevation with the aid of a properly functioning deltoid muscle. The technique was recently adapted from open to arthroscopically assisted with numerous advantages. We propose a combined fully arthroscopic technique for transfer of latissimus dorsi and teres major in which the tendons are fixed in a flat manner at the junction of supraspinatus and infraspinatus to decrease failure rate.

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Comparison of arthroscopically assisted transfer of the latissimus dorsi with or without partial cuff repair for irreparable postero-superior rotator cuff tear

Abstract: Treatment study, Level II.

Cited by 13 publications

References 28 publications

Multiple surgical treatment comparisons for irreparable rotator cuff tears: A network meta-analysis

Multiple surgical treatment comparisons for irreparable rotator cuff tears: A network meta-analysis

Clinical outcomes of latissimus dorsi tendon transfer and superior capsular reconstruction for irreparable rotator cuff tears: a systematic review

Combined Fully Arthroscopic Transfer of Latissimus Dorsi and Teres Major for Treatment of Irreparable Posterosuperior Rotator Cuff Tears

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