Posterior latissimus dorsi transfer for massive irreparable posterosuperior rotator cuff tears: does it work in the elderly population? A comparative study between 2 age groups (≤55 vs. ≥75 years old)

Kany, Jean; Sekakaran, Padmanaban; Amavarathi, Rajkumar S.; Patil, Prateek; Grimberg, Jean; Valenti, Philippe; Werthel, Jean David

doi:10.1016/j.jse.2020.06.018

Cited by 16 publications

(17 citation statements)

References 44 publications

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“…The latissimus dorsi transfer technique has a high rupture rate of 38% [23]. In this study, when we compared patients aged ≤ 55 years and ≥ 75 years, the re-tear rates were 33% and 26%, respectively, but there was no significant difference in the clinical outcomes and satisfaction rates, suggesting that it is a useful procedure for patients aged ≥ 75 years [24]. SCR has been increasingly investigated and reported in recent years.…”

Section: Discussionmentioning

confidence: 75%

The clinical outcomes of infraspinatus rotational transfer for irreparable posterosuperior rotator cuff tears: a preliminary report

Harada¹,

Ishitani

Gotoh

et al. 2022

Clin Shoulder Elbow

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Background: This study aimed to examine the preliminary clinical results of the infraspinatus rotational transfer procedure for irreparable posterosuperior rotator cuff tears.Methods: This study included 34 patients (mean age, 68.4 years). Their mean tear width and length measurements were 50.9 mm and 50.6 mm, respectively. The functional outcomes, including physician-determined and patient-reported scores, were evaluated before and at 1 year after surgery. The structural outcomes determined using the magnetic resonance imaging examination results were also assessed.Results: The clinical scores significantly improved after surgery compared with the scores before surgery: the Constant-Murley score (53.3±21.1 to 76.8±10.5), University of California at Los Angeles Shoulder score (15.6±3.6 to 27.8±6.7), American Shoulder and Elbow Surgeons Shoulder score (51.8±18.3 to 89.1±13.7), and WORC score (925.0±436.8 to 480.3±373.2) (all P<0.0000). Postoperative re-tears were noted in two patients (5.9%).Conclusion: One year postoperatively, the patient’s clinical scores significantly improved, with a re-tear rate of 5.9%.

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Section: Discussionmentioning

confidence: 75%

The clinical outcomes of infraspinatus rotational transfer for irreparable posterosuperior rotator cuff tears: a preliminary report

Harada¹,

Ishitani

Gotoh

et al. 2022

Clin Shoulder Elbow

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“…1). There were 3 Level II studies, [52, 71, 87], 14 Level III studies [10, 18, 39, 42, 49, 50, 53, 55, 56, 62, 63, 65, 68, 76], and 69 Level IV studies [3, 4, 6, 8, 9, 11–13, 15–17, 19–33, 35, 37, 38, 41, 43, 45, 47, 48, 51, 54, 57–61, 64, 66, 67, 69, 72–75, 77–81, 84–86, 88–95]. The mean MINORS score was 18 for the 14 comparative studies and 8 for the 69 noncomparative studies.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 10 studies reported abduction range of motion measurements preoperatively and postoperatively, with a total of 3 subgroups represented (Table 3). There were two studies in the debridement subgroup [60, 89], two studies in the repair subgroup, [18, 47], and six studies in the tendon transfer subgroup [19, 27, 37–39, 84]. All three subgroups had statistically significant improvements in abduction range of motion ( p < 0.050).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 15 studies reported forward flexion range of motion measurements preoperatively and postoperatively, with a total of five subgroups represented (Table 5). There were two studies in the debridement subgroup [60, 89], five studies in the repair subgroup [13, 18, 47, 53, 69], 5 studies in the SCR subgroup [16, 42, 51, 56, 57], four studies in the spacer subgroup [53, 54, 65, 75], and 11 studies in the tendon transfer subgroup [3, 19, 27, 30, 37–39, 64, 69, 84, 94]. All subgroups showed statistically significant improvement in forward flexion range of motion ( p < 0.050 for all).…”

Section: Resultsmentioning

confidence: 99%

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Nonarthroplasty options for massive, irreparable rotator cuff tears have improvement in range of motion and patient-reported outcomes at short-term follow-up: a systematic review

Hughes

Davis

Whicker

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeTo compare various nonarthroplasty treatment options for massive, irreparable rotator cuff tears, including allograft bridging/augmentation, debridement, partial repair, superior capsule reconstruction (SCR), subacromial balloon spacer, and tendon transfer. MethodsA comprehensive search was conducted through the PubMed, MEDLINE, and EMBASE databases for all articles pertaining to nonarthroplasty treatment options for irreparable rotator cuff tears. Inclusion criteria included manuscripts published between 2009 and 2020 with at least 1 year follow‐up and Level I–IV evidence. Articles were separated into six groups: debridement, arthroscopic and open repair, allograft bridging/augmentation, SCR, subacromial balloon spacer, and tendon transfer. Data points included range of motion (external rotation, abduction, forward flexion, and internal rotation), visual analog scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, Constant score, rate of revision surgery, and rate of conversion to arthroplasty. ResultsA total of 83 studies and 3363 patients were included. All treatment options had statistically significant improvements in postoperative range of motion and patient‐reported outcomes. Debridement had statistically significantly greater postoperative abduction and forward flexion range of motion, as well as better VAS pain scores, compared to the other treatment options. The SCR subgroup had the greatest improvement in ASES scores postoperatively. The overall revision rate was 7.2% among all surgical options, with the allograft bridging/augmentation group having the lowest rate of revision at 0–8.3%. The overall rate of conversion to arthroplasty was 7.2%, with debridement having the greatest rate of conversion at 15.4%. ConclusionAll six nonarthroplasty treatment options for irreparable rotator cuff tears resulted in statistically significant improvements in range of motion and patient‐reported outcomes at 1 year follow‐up or more, with low rates of revision and conversion to arthroplasty. Debridement had statistically significantly greater postoperative abduction and forward flexion range of motion, as well as better VAS pain scores, compared to the other treatment options. However, these conclusions should be interpreted with caution due to the heterogeneous nature of the data, lack of prospective randomized control trials, and short‐term follow‐up. The findings of this study highlight the complexity of irreparable, massive rotator cuff tears, and the need for an individualized approach when treating these patients. Level of evidenceLevel IV.

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“…Posterior latissimus dorsi tendon transfer (LDTT) has demonstrated satisfactory outcomes to treat posterosuperior mRCTs regardless of patient age. 15 , 18 , 20 …”

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confidence: 99%

Matched Cohort Study Comparing Arthroscopic-Assisted Versus Full-Arthroscopic Latissimus Dorsi Tendon Transfer for Irreparable Massive Rotator Cuff Tears

Kany

Meirlaen

Werthel

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Latissimus dorsi tendon transfer (LDTT) is increasingly performed with arthroscopic assistance, requiring an open axillary incision, which could increase risks of infection, hematoma, and lymphoedema. Technological advancements now enable LDTT to be fully arthroscopic, but its benefits and safety have not yet been confirmed. Purpose: To compare the clinical outcomes and complication rates of arthroscopic-assisted versus full-arthroscopic LDTT for irreparable posterosuperior massive rotator cuff tears in shoulders with no surgical antecedents. Study Design: Cohort study; Level of evidence, 3. Methods: The study included 90 patients who had undergone LDTT over 4 consecutive years by the same surgeon and did not have prior surgery. During the first 2 study years, all procedures were arthroscopically assisted (n = 52), while during the last 2 years, all procedures were fully arthroscopic (n = 38). Procedure duration and all complications were recorded, as well as clinical scores and range of motion at minimum 24-month follow-up. To enable direct comparison between the techniques, propensity score matching was used to obtain 2 groups with equivalent age, sex, and follow-up. Results: From the initial cohort of 52 patients who underwent arthroscopic-assisted LDTT, 8 had complications (15.4%), of which 3 (5.7%) required conversion to reverse shoulder arthroplasty and 2 (3.8%) required drainage or lavage. From the initial cohort of 38 patients who had full-arthroscopic LDTT, 5 had complications (13.2%), of which 2 (5.2%) required conversion to reverse shoulder arthroplasty but no patients (0%) required other procedures. Propensity score matching resulted in 2 groups, each comprising 31 patients, with similar outcomes in terms of clinical scores and range of motion. The procedure time was about 18 minutes shorter for full-arthroscopic LDTT, which had different complications (2 axillary nerve pareses) as compared with arthroscopic-assisted LDTT (1 hematoma and 2 infections). Conclusion: Equivalent outcomes at minimum 24-month follow-up were found for arthroscopic-assisted and full-arthroscopic LDTT in terms of complications rates (15.4% and 13.2%, respectively), conversion to reverse shoulder arthroplasty (5.7% and 5.2%), clinical scores, and range of motion.

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Posterior latissimus dorsi transfer for massive irreparable posterosuperior rotator cuff tears: does it work in the elderly population? A comparative study between 2 age groups (≤55 vs. ≥75 years old)

Cited by 16 publications

References 44 publications

The clinical outcomes of infraspinatus rotational transfer for irreparable posterosuperior rotator cuff tears: a preliminary report

The clinical outcomes of infraspinatus rotational transfer for irreparable posterosuperior rotator cuff tears: a preliminary report

Nonarthroplasty options for massive, irreparable rotator cuff tears have improvement in range of motion and patient-reported outcomes at short-term follow-up: a systematic review

Matched Cohort Study Comparing Arthroscopic-Assisted Versus Full-Arthroscopic Latissimus Dorsi Tendon Transfer for Irreparable Massive Rotator Cuff Tears

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