Isolated loss of active external rotation: a distinct entity and results of L'Episcopo tendon transfer

Boileau, Pascal; Baba, Mohammed; McClelland, Walter B.; Thélu, Charles-Édouard; Trojani, Christophe; Bronsard, Nicolas

doi:10.1016/j.jse.2017.07.008

Cited by 37 publications

(28 citation statements)

References 36 publications

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“…This could lead to poor active motion, so some authors advocate for the association of tendon transfers, particularly for external rotation. 38 The present study has some limitations. First, the status of the rotator cuff may be different between groups.…”

Section: Discussionmentioning

confidence: 81%

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Anatomic total shoulder arthroplasty with posterior capsular plication versus reverse shoulder arthroplasty in patients with biconcave glenoids: A matched cohort study

Alentorn-Geli

Wanderman

Assenmacher

et al. 2018

J Orthop Surg (Hong Kong)

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Purpose: To compare the outcomes of total shoulder arthroplasty (TSA) with posterior capsule plication (PCP) and reverse shoulder arthroplasty (RSA) in patients with primary osteoarthritis, posterior subluxation, and bone loss (Walch B2). Patients and methods: All shoulders undergoing anatomic TSA with PCP were retrospectively identified (group 1, G1) and compared to shoulders undergoing RSA (group 2, G2) for Walch B2 osteoarthritis. There were 15 patients in G1 (mean (SD) age and follow-up of 70.5 (7.5) years and 42.8 (18.4) months, respectively) and 16 patients in G2 (mean (SD) age and follow-up of 72.6 (5.4) years and 35.1 (14.2) months, respectively). Results: Both groups had substantial improvements in pain and function. In G1, results were excellent in 80% and satisfactory in 20%, compared to 81% and 6% in G2, respectively (p ¼ 0.2). The mean (SD) American Shoulder and Elbow Surgeons score was 91.2 (6.7) and 80.3 (14.3) in G1 and G2, respectively (p ¼ 0.08). The mean Simple Shoulder Test score was 10.6 in G1 and 8.5 in G2 (p ¼ 0.01). There were no reoperations in either group, but G1 had seven postoperative complications. Conclusions: The outcomes of TSA with PCP are comparable to RSA in patients with osteoarthritis and biconcave glenoids. However, TSA leads to more complications while RSA leads to lower functional outcomes.

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Section: Discussionmentioning

confidence: 81%

“…This could lead to poor active motion, so some authors advocate for the association of tendon transfers, particularly for external rotation. 38…”

Section: Discussionmentioning

confidence: 99%

Anatomic total shoulder arthroplasty with posterior capsular plication versus reverse shoulder arthroplasty in patients with biconcave glenoids: A matched cohort study

Alentorn-Geli

Wanderman

Assenmacher

et al. 2018

J Orthop Surg (Hong Kong)

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“…The conjoined tendon of the latissimus dorsi and teres major muscles needs to be cut off. But its function is almost unaffected because Modi ed L'Episcope procedure have been proposed [39].The follow-up shows that active internal rotation remained unchanged (7.6 ± 2.0 compared to 7.5 ± 2.4). So, the dissection of the conjoined tendon will not affect the function of the shoulder.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Study for the Treatment of Proximal Humeral Fracture Through the Medial Approach

Xiang

Wang

Yang

et al. 2021

Preprint

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Background: The treatment of complex 3- and 4- part proximal humeral fractures has been controversial due to numerous postoperative complications. With the further study of medial support and blood supply of humeral head, new techniques and conception are developing. The study aims to illustrate the medial approach of the proximal humeral fracture through cadaver autopsy.Method: Upper limbs from 19 cadavers have been dissected to expose the shoulder joint. We selected the coracoid process as the bony reference. Vernier caliper will be used to measure the following data, including distance from coracoid process to circumflex brachial artery, distance between anterior humeral circumflex artery (ACHA) and posterior circumflex brachial artery (PCHA) and their diameters. Assessment included the characteristics of the vascular supply around the humeral head, identification of the structures at risk, quality of exposure of the bony structures, and feasibility of fixation.Results: Medial plate can be easily placed in 86.84% anatomical patterns. An interval of 2 to 3cm (24.29 ± 3.42 mm) was available for internal fixation. ACHA (49.35 ± 8.13 mm, 35.14 - 68.53 mm) and PCHA (49.62 ± 7.82 mm, 37.67 - 66.76 mm) were about 5cm away from the coracoid process. Risk factors including ACHA and PCHA originate in common, PCHA originated from the deep brachial artery (DBA), the presence of perforator vessels; musculocutaneous nerve intersects with ACHA, the diameter of PCHA: ACHA < 1.5. In 13.15% anatomical patterns, this risk factor should be taken seriously. Conclusion: The medial approach opens a new perspective in the optimal management of complex fractures of proximal humerus. Anatomical research proves that the medial approach is feasible. The interval between ACHA and PCHA is suitable for placement. Anatomical pattern and indication have been discussed, and we hypothesized that ACHA has been destroyed in complex PHFs. With further studies on the anatomy and mechanism of injury, the development of more clinical cases will be an important work of our institution in the future.

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“…Latissimus dorsi muscle transfer for mRCTs also sacrifices normal tissue, has poor recovery of muscle strength after surgery, and may cause osteoarthritis in the future. 20,30 However, good outcomes have been reported from reverse shoulder arthroplasty 2,10,45 and from SSC tendon transfer and small-head hemiarthroplasty. 44 Because these replacement surgeries use an artificial prosthesis, there are concerns about future loosening of the components and deterioration of the outcomes.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Rotator Cuff Repair With Muscle Advancement and Artificial Biodegradable Sheet Reinforcement for Massive Rotator Cuff Tears

Yokoya

Harada

Negi

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Because high failure rates have frequently been reported after arthroscopic rotator cuff repair (ARCR) of massive rotator cuff tears (mRCTs), we introduced the technique of ARCR with supraspinatus and infraspinatus muscle advancement (MA). However, for cases where the original footprint cannot be completely covered, additional surgery using an approved artificial biomaterial is performed. Purpose: To investigate the postoperative clinical outcomes and failure rate after MA-ARCR, with and without our reinforcement technique. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 74 patients (mean ± SD age, 68.7 ± 7.7 years) diagnosed with mRCT with a minimum postoperative follow-up of 2 years were included in the current study. Of these patients, 47 underwent MA-ARCR with polyglycolic acid (PGA) sheet reinforcement (study group), and 27 patients underwent MA-ARCR alone (control group). PGA reinforcement was performed when full coverage of the footprint could not be achieved by MA alone, but where the latter was possible, reinforcement was not required. Thus, the study group had significantly worse muscle quality than the control group ( P < .05). The pre- and postoperative range of motion (ROM), isometric muscle strength, acromiohumeral interval, and clinical outcomes were evaluated and compared between these 2 groups. Cuff integrity during the last follow-up period was assessed with magnetic resonance imaging, and the failure rate was calculated. In addition, the postoperative foreign body reaction was investigated in the study group. Results: In both groups, significant postoperative improvements were seen in acromiohumeral interval, clinical scores, ROM in anterior flexion, and isometric muscle strength in abduction, external rotation, and internal rotation ( P < .001 for all). The failure rate of the study group was 12.8% (6 patients) and that of the control group was 25.9% (7 patients). No significant differences were noted between the 2 groups on any of the data findings, even regarding the failure rate. Foreign body reactions in the early period were found in 3 patients, although these spontaneously disappeared within 3 months. Conclusion: Patients who underwent PGA patch reinforcement for MA-ARCR when the footprint could not be completely covered had clinical results similar to isolated MA-ARCR when the footprint could be covered. Both procedures resulted in significant improvement in symptoms and function compared with preoperatively.

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Isolated loss of active external rotation: a distinct entity and results of L'Episcopo tendon transfer

Cited by 37 publications

References 36 publications

Anatomic total shoulder arthroplasty with posterior capsular plication versus reverse shoulder arthroplasty in patients with biconcave glenoids: A matched cohort study

Anatomic total shoulder arthroplasty with posterior capsular plication versus reverse shoulder arthroplasty in patients with biconcave glenoids: A matched cohort study

Anatomical Study for the Treatment of Proximal Humeral Fracture Through the Medial Approach

Arthroscopic Rotator Cuff Repair With Muscle Advancement and Artificial Biodegradable Sheet Reinforcement for Massive Rotator Cuff Tears

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