Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Ortopedia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000400590 |
Resumo: | Abstract Objective The primary aim of the present study is to evaluate the functional results of a modification to the latissimus dorsi (LD) transfer around the shoulder for irreparable posterosuperior rotator cuff tears. The secondary aim is to evaluate variables that might influence the outcomes. Surgical Technique Through a single deltopectoral approach, the LD tendon is detached, reinforced, and elongated with a tendinous allograft, transferred around the humerus, and fixed superolaterally to the greater tuberosity and anteriorly to the subscapularis. Methods Retrospective functional evaluation of 16 cases. The average follow-up was 21 months (12-47). The postoperative results (at last follow-up) were compared with the preoperative ones, as well as to other pre, intra, and postoperative variables. Results All (but one) patients were satisfied. Average University of California, Los Angeles (UCLA) score increased from 11.6 (8-16) to 27.3 (17-30) (p< 0.001). Improvements of shoulder pain, function, and strength achieved statistical significance (p< 0.001). Nonetheless, normal strength was never restored. Average active range of motion improved as follows: forward elevation, from 106° (60-140°) to 145° (130-160°) (p< 0.001); external rotation from 30° (0° to 60°) to 54° (40-70°) (p< 0.001); and internal rotation from L1 (gluteus to T7) to T10 (T12-T3) (p< 0.05). No complication has occurred. Preoperative pseudoparesis was reverted in all the six cases in which it was present. None of the variables analyzed influenced the outcomes, including pseudoparesis. Conclusions At early follow-up, this technique is safe and effective at recovering from pseudoparesis and at improving shoulder pain, function, and strength. |
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Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tearsrotator cuff injuriestendon transfershoulderorthopedic proceduresAbstract Objective The primary aim of the present study is to evaluate the functional results of a modification to the latissimus dorsi (LD) transfer around the shoulder for irreparable posterosuperior rotator cuff tears. The secondary aim is to evaluate variables that might influence the outcomes. Surgical Technique Through a single deltopectoral approach, the LD tendon is detached, reinforced, and elongated with a tendinous allograft, transferred around the humerus, and fixed superolaterally to the greater tuberosity and anteriorly to the subscapularis. Methods Retrospective functional evaluation of 16 cases. The average follow-up was 21 months (12-47). The postoperative results (at last follow-up) were compared with the preoperative ones, as well as to other pre, intra, and postoperative variables. Results All (but one) patients were satisfied. Average University of California, Los Angeles (UCLA) score increased from 11.6 (8-16) to 27.3 (17-30) (p< 0.001). Improvements of shoulder pain, function, and strength achieved statistical significance (p< 0.001). Nonetheless, normal strength was never restored. Average active range of motion improved as follows: forward elevation, from 106° (60-140°) to 145° (130-160°) (p< 0.001); external rotation from 30° (0° to 60°) to 54° (40-70°) (p< 0.001); and internal rotation from L1 (gluteus to T7) to T10 (T12-T3) (p< 0.05). No complication has occurred. Preoperative pseudoparesis was reverted in all the six cases in which it was present. None of the variables analyzed influenced the outcomes, including pseudoparesis. Conclusions At early follow-up, this technique is safe and effective at recovering from pseudoparesis and at improving shoulder pain, function, and strength.Sociedade Brasileira de Ortopedia e Traumatologia2022-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000400590Revista Brasileira de Ortopedia v.57 n.4 2022reponame:Revista Brasileira de Ortopedia (Online)instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)instacron:SBOT10.1055/s-0041-1724073info:eu-repo/semantics/openAccessMiyazaki,Alberto NaokiChecchia,Caio SantosFonseca Filho,João ManoelRosa,João Roberto PolydoroSella,Guilherme do ValSilva,Luciana Andrade daeng2022-08-26T00:00:00Zoai:scielo:S0102-36162022000400590Revistahttp://www.rbo.org.br/https://old.scielo.br/oai/scielo-oai.php||rbo@sbot.org.br1982-43780102-3616opendoar:2022-08-26T00:00Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)false |
dc.title.none.fl_str_mv |
Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears |
title |
Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears |
spellingShingle |
Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears Miyazaki,Alberto Naoki rotator cuff injuries tendon transfer shoulder orthopedic procedures |
title_short |
Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears |
title_full |
Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears |
title_fullStr |
Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears |
title_full_unstemmed |
Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears |
title_sort |
Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears |
author |
Miyazaki,Alberto Naoki |
author_facet |
Miyazaki,Alberto Naoki Checchia,Caio Santos Fonseca Filho,João Manoel Rosa,João Roberto Polydoro Sella,Guilherme do Val Silva,Luciana Andrade da |
author_role |
author |
author2 |
Checchia,Caio Santos Fonseca Filho,João Manoel Rosa,João Roberto Polydoro Sella,Guilherme do Val Silva,Luciana Andrade da |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Miyazaki,Alberto Naoki Checchia,Caio Santos Fonseca Filho,João Manoel Rosa,João Roberto Polydoro Sella,Guilherme do Val Silva,Luciana Andrade da |
dc.subject.por.fl_str_mv |
rotator cuff injuries tendon transfer shoulder orthopedic procedures |
topic |
rotator cuff injuries tendon transfer shoulder orthopedic procedures |
description |
Abstract Objective The primary aim of the present study is to evaluate the functional results of a modification to the latissimus dorsi (LD) transfer around the shoulder for irreparable posterosuperior rotator cuff tears. The secondary aim is to evaluate variables that might influence the outcomes. Surgical Technique Through a single deltopectoral approach, the LD tendon is detached, reinforced, and elongated with a tendinous allograft, transferred around the humerus, and fixed superolaterally to the greater tuberosity and anteriorly to the subscapularis. Methods Retrospective functional evaluation of 16 cases. The average follow-up was 21 months (12-47). The postoperative results (at last follow-up) were compared with the preoperative ones, as well as to other pre, intra, and postoperative variables. Results All (but one) patients were satisfied. Average University of California, Los Angeles (UCLA) score increased from 11.6 (8-16) to 27.3 (17-30) (p< 0.001). Improvements of shoulder pain, function, and strength achieved statistical significance (p< 0.001). Nonetheless, normal strength was never restored. Average active range of motion improved as follows: forward elevation, from 106° (60-140°) to 145° (130-160°) (p< 0.001); external rotation from 30° (0° to 60°) to 54° (40-70°) (p< 0.001); and internal rotation from L1 (gluteus to T7) to T10 (T12-T3) (p< 0.05). No complication has occurred. Preoperative pseudoparesis was reverted in all the six cases in which it was present. None of the variables analyzed influenced the outcomes, including pseudoparesis. Conclusions At early follow-up, this technique is safe and effective at recovering from pseudoparesis and at improving shoulder pain, function, and strength. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-08-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000400590 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000400590 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1055/s-0041-1724073 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Ortopedia e Traumatologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Ortopedia e Traumatologia |
dc.source.none.fl_str_mv |
Revista Brasileira de Ortopedia v.57 n.4 2022 reponame:Revista Brasileira de Ortopedia (Online) instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT) instacron:SBOT |
instname_str |
Sociedade Brasileira de Ortopedia e Traumatologia (SBOT) |
instacron_str |
SBOT |
institution |
SBOT |
reponame_str |
Revista Brasileira de Ortopedia (Online) |
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Revista Brasileira de Ortopedia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT) |
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||rbo@sbot.org.br |
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1752122363578679296 |