Pectoralis minor tendon transfer for irreparable anterosuperior cuff tears

Paladini, Paolo; Campi, Fabrizio; Merolla, Giovanni; Pellegrini, Andrea; Porcellini, Giuseppe

doi:10.1016/j.jse.2012.12.030

Cited by 61 publications

(48 citation statements)

References 33 publications

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“…79 Investigators looked at other interventions including a PMnT. 72,80 Wirth initially described this transfer in 1997 while reporting outcomes on both PMT and PMnT. Paladini used a subcoracoid PMnT with a small cortical piece of the coracoid for subscapularis tears of the superior two-thirds concomitant with irreparable supraspinatus tears.…”

Section: Irreparable Anterosuperior Rctsmentioning

confidence: 99%

Tendon transfers for irreparable rotator cuff tears: An update

Axe¹

2016

EFORT Open Reviews

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Shoulder dysfunction in the setting of irreparable rotator cuff tears (RCTs) can be treated successfully with different types of tendon transfer:Latissimus dorsi transfer for irreparable posterosuperior RCTs works best for young, active patients with an intact subscapularis, no pseudoparalysis or previous surgery, and a functioning teres minor.A more anatomical transfer for irreparable posterosuperior RCTs is a lower trapezius transfer, and early results are promising.Isolated irreparable tears of the subscapularis can be successfully managed with pectoralis major tendon transfer with a concentric humeral head. However, restricted external rotation (ER) may occur, depending on technique.Pectoralis minor transfer can successfully address combination irreparable tears of the upper border subscapularis and the supraspinatus without significant loss of ER.Rotator cuff arthropathy with ER lag benefits most from a reverse total shoulder arthroplasty and a combination latissimus dorsi and teres major transfer (LDTMT) regardless of patient age.Cite this article: Axe JM. Tendon transfers for irreparable rotator cuff tears: An update. EFORT Open Rev 2016;1:18-24. doi: 10.1302/2058-5241.1.000003

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Section: Irreparable Anterosuperior Rctsmentioning

confidence: 99%

Tendon transfers for irreparable rotator cuff tears: An update

Axe¹

2016

EFORT Open Reviews

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“…Many patients with irreparable RCT respond favorably to nonsurgical treatment 27 . When 31 Size, retraction Arthroscopy Patte 32 Location, size, retraction, muscle quality, state of the LHB MRI Ellmann & Gartsman 30 Morphology Arthroscopy Lafosse 36 Isolated subscapularis tear Arthroscopy Goutallier 33 Muscle fatty degeneration CT scan Fuchs 34 Muscle fatty degeneration MRI glenohumeral joint and thus replacing the function of the posterior force couple 10 . Aim of PMa transfer is to exert an internal rotation centering force there by replacing the function of the subscapularis.…”

Section: Tendon Transfer Procedures: Rationalementioning

confidence: 99%

“…The bellies of the inferior subscapularis and of the PMi can be joined horizontally with 2 free sutures and the biceps tenodesized or tenotomized. After the operation, the shoulder is immobilized in a sling for 6 weeks, active elbow flexion and extension are allowed with the arm at the side; at 6 weeks, the sling is removed and passive mobilizations in forward flexion and passive external rotation are permitted 31,60 . After 8 weeks all range-of-motion (ROM) restrictions were lifted, strengthening is initiated at 3 months 31 .…”

Section: Pectoralis Minor Transfermentioning

confidence: 99%

“…Moreover, irreparable RCT typically present with atrophy and fatty degeneration of the respective muscles that lead to impaired muscle quality and thus to defective contracconservative measures fail to improve the patient's pain and disability, surgery should be considered. Surgical options include arthroscopic débridement with or without partial rotator cuff repair 28 , the use of rotator cuff allografts and synthetic grafts 29 , arthroplasty 30 and tendon transfer 2,10,[31][32][33] . Among these techniques, the transposition of the surrounding muscles to replace the rotator cuff function represents a viable option.…”

Section: Introductionmentioning

confidence: 99%

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Tendon transfer for irreparable rotator cuff tears: indications and surgical rationale

Merolla

Chillemi

Franceschini

et al. 2014

MLTJ

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SummaryBackground: treatment of symptomatic irreparable rotator cuff tears is extremely challenging because, at present, there are no ideal solutions to this problem. Many patients respond favorably to nonsurgical treatment. However, when conservative measures fail to improve the patient's pain and disability, surgery should be considered. Methods: different surgical techniques are available and the choice of the most appropriate procedure depends on the presenting symptoms, age of the patient, functional demand, medical comorbidities, joint stability and presence of arthritic changes. The transposition of the surrounding muscles to replace the rotator cuff function represents a viable option in the treatment of younger patients without glenohumeral osteoarthritis and

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“…12 Accordingly, detailed anatomy of the rotator interval area is of interest. One of the anatomic variations in this region is the anomalous, tendinous insertion of the pectoralis minor muscle.…”

mentioning

confidence: 99%