Latissimus dorsi transfer or lower trapezius transfer: a treatment algorithm for irreparable posterosuperior rotator cuff tears muscles transfers in posterosuperior rotator cuff tears
Background: Tendon transfers of the latissimus dorsi transfer (LDT) or the lower trapezius transfer (LTT) are treatment options for irreparable posterosuperior irreparable rotator cuff tears (PSIRCT). There is still no consensus on which type of tendon transfer is superior in the treatment of PSIRCT...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | JSES International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638324003761 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841545480900706304 |
|---|---|
| author | Michael Kimmeyer, MD Tilman Hees, MD Laurens Allaart, MD Rémi Nerot, MD Arno Macken, MD Geert-Alexander Buijze, MD, PhD, FEBHS Laurent Lafosse, MD Thibault Lafosse, MD |
| author_facet | Michael Kimmeyer, MD Tilman Hees, MD Laurens Allaart, MD Rémi Nerot, MD Arno Macken, MD Geert-Alexander Buijze, MD, PhD, FEBHS Laurent Lafosse, MD Thibault Lafosse, MD |
| author_sort | Michael Kimmeyer, MD |
| collection | DOAJ |
| description | Background: Tendon transfers of the latissimus dorsi transfer (LDT) or the lower trapezius transfer (LTT) are treatment options for irreparable posterosuperior irreparable rotator cuff tears (PSIRCT). There is still no consensus on which type of tendon transfer is superior in the treatment of PSIRCT. Due to the differences in the anatomy and biomechanics, we hypothesize that there are different clinical situations in which either LDT or LTT should be preferred. The aim of this study was to evaluate the clinical and radiological outcomes of LDT and LTT in patients with PSIRCT to establish a clinical algorithm for the treatment decision. Materials and methods: This is a retrospective, single-center observational study. Included were patients who underwent arthroscopically assisted LDT (aaLDT) or arthroscopically assisted LTT (aaLTT) for PSIRCT. In all patients, range of motion (ROM), external rotation strength, visual analog scale of pain and subjective shoulder value were determined pre- and postoperatively. Constant–Murley score was evaluated at the final follow-up. The complication rate, failure of the tendon transfer, and revision rate were analyzed. Results: In total, 29 aaLDT (age 64 years, median follow-up time 45 months) and 8 aaLTT (age 54 years, median follow-up time 34 months) were included. Active ROM, visual analog scale and subjective shoulder value was significantly improved in both cohorts. At follow-up, the median Constant–Murley score was 73 (aaLDT) and 77 (aaLTT), respectively. The failure rate, including revision surgery, was 14% (aaLDT) and 13% (aaLTT), respectively. Low functional findings preoperatively were correlated to a lower functional outcome at follow-up in both groups. Painful loss of anterior elevation and loss of external rotation had no significant impact on functional outcomes in aaLDT. Conclusion: Following the treatment algorithm based on the clinical examination, clinical outcome parameters, active ROM and pain could be significantly improved. A good preoperative function was associated with a good clinical outcome in both transfers. A low failure and revision rate supports the good decision-making of the algorithm presented. |
| format | Article |
| id | doaj-art-0131c70d5ae249c09f0a8ad539865865 |
| institution | Kabale University |
| issn | 2666-6383 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj-art-0131c70d5ae249c09f0a8ad5398658652025-01-12T05:25:57ZengElsevierJSES International2666-63832025-01-01917985Latissimus dorsi transfer or lower trapezius transfer: a treatment algorithm for irreparable posterosuperior rotator cuff tears muscles transfers in posterosuperior rotator cuff tearsMichael Kimmeyer, MD0Tilman Hees, MD1Laurens Allaart, MD2Rémi Nerot, MD3Arno Macken, MD4Geert-Alexander Buijze, MD, PhD, FEBHS5Laurent Lafosse, MD6Thibault Lafosse, MD7Alps Surgery Institute, Clinique Générale Annecy, Annecy, France; Department of Trauma, Hand Surgery and Sports Medicine, ViDia Clinics Karlsruhe, Karlsruhe, Germany; Corresponding author: Michael Kimmeyer, MD, Department of Traumatology and Hand Surgery, St. Vincentius Clinic, ViDia Clinics. Steinhaeusserstr. 18, Karlsruhe D-76135, Germany.Alps Surgery Institute, Clinique Générale Annecy, Annecy, France; ORTHO EINS Orthopäden Berlin, Berlin, GermanyAlps Surgery Institute, Clinique Générale Annecy, Annecy, France; Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Shoulder and Elbow Unit, Joint Research, Department of Orthopaedic Surgery, OLVG, Amsterdam, The NetherlandsAlps Surgery Institute, Clinique Générale Annecy, Annecy, France; Department of Orthopaedics and Traumatology, University Hospital of Bordeaux, Bordeaux, FranceAlps Surgery Institute, Clinique Générale Annecy, Annecy, France; Department of Orthopaedics and Sports medicine, Erasmus MC, Rotterdam, The NetherlandsAlps Surgery Institute, Clinique Générale Annecy, Annecy, France; Hand and Upper Extremity Surgery Unit, CHU Lapeyronie, University of Montpellier, Montpellier, France; Department of Orthopaedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsAlps Surgery Institute, Clinique Générale Annecy, Annecy, FranceAlps Surgery Institute, Clinique Générale Annecy, Annecy, FranceBackground: Tendon transfers of the latissimus dorsi transfer (LDT) or the lower trapezius transfer (LTT) are treatment options for irreparable posterosuperior irreparable rotator cuff tears (PSIRCT). There is still no consensus on which type of tendon transfer is superior in the treatment of PSIRCT. Due to the differences in the anatomy and biomechanics, we hypothesize that there are different clinical situations in which either LDT or LTT should be preferred. The aim of this study was to evaluate the clinical and radiological outcomes of LDT and LTT in patients with PSIRCT to establish a clinical algorithm for the treatment decision. Materials and methods: This is a retrospective, single-center observational study. Included were patients who underwent arthroscopically assisted LDT (aaLDT) or arthroscopically assisted LTT (aaLTT) for PSIRCT. In all patients, range of motion (ROM), external rotation strength, visual analog scale of pain and subjective shoulder value were determined pre- and postoperatively. Constant–Murley score was evaluated at the final follow-up. The complication rate, failure of the tendon transfer, and revision rate were analyzed. Results: In total, 29 aaLDT (age 64 years, median follow-up time 45 months) and 8 aaLTT (age 54 years, median follow-up time 34 months) were included. Active ROM, visual analog scale and subjective shoulder value was significantly improved in both cohorts. At follow-up, the median Constant–Murley score was 73 (aaLDT) and 77 (aaLTT), respectively. The failure rate, including revision surgery, was 14% (aaLDT) and 13% (aaLTT), respectively. Low functional findings preoperatively were correlated to a lower functional outcome at follow-up in both groups. Painful loss of anterior elevation and loss of external rotation had no significant impact on functional outcomes in aaLDT. Conclusion: Following the treatment algorithm based on the clinical examination, clinical outcome parameters, active ROM and pain could be significantly improved. A good preoperative function was associated with a good clinical outcome in both transfers. A low failure and revision rate supports the good decision-making of the algorithm presented.http://www.sciencedirect.com/science/article/pii/S2666638324003761Tendon transferLDT transferLTT transferPseudoparalysisPseudoparesisPainful loss of anterior elevation |
| spellingShingle | Michael Kimmeyer, MD Tilman Hees, MD Laurens Allaart, MD Rémi Nerot, MD Arno Macken, MD Geert-Alexander Buijze, MD, PhD, FEBHS Laurent Lafosse, MD Thibault Lafosse, MD Latissimus dorsi transfer or lower trapezius transfer: a treatment algorithm for irreparable posterosuperior rotator cuff tears muscles transfers in posterosuperior rotator cuff tears JSES International Tendon transfer LDT transfer LTT transfer Pseudoparalysis Pseudoparesis Painful loss of anterior elevation |
| title | Latissimus dorsi transfer or lower trapezius transfer: a treatment algorithm for irreparable posterosuperior rotator cuff tears muscles transfers in posterosuperior rotator cuff tears |
| title_full | Latissimus dorsi transfer or lower trapezius transfer: a treatment algorithm for irreparable posterosuperior rotator cuff tears muscles transfers in posterosuperior rotator cuff tears |
| title_fullStr | Latissimus dorsi transfer or lower trapezius transfer: a treatment algorithm for irreparable posterosuperior rotator cuff tears muscles transfers in posterosuperior rotator cuff tears |
| title_full_unstemmed | Latissimus dorsi transfer or lower trapezius transfer: a treatment algorithm for irreparable posterosuperior rotator cuff tears muscles transfers in posterosuperior rotator cuff tears |
| title_short | Latissimus dorsi transfer or lower trapezius transfer: a treatment algorithm for irreparable posterosuperior rotator cuff tears muscles transfers in posterosuperior rotator cuff tears |
| title_sort | latissimus dorsi transfer or lower trapezius transfer a treatment algorithm for irreparable posterosuperior rotator cuff tears muscles transfers in posterosuperior rotator cuff tears |
| topic | Tendon transfer LDT transfer LTT transfer Pseudoparalysis Pseudoparesis Painful loss of anterior elevation |
| url | http://www.sciencedirect.com/science/article/pii/S2666638324003761 |
| work_keys_str_mv | AT michaelkimmeyermd latissimusdorsitransferorlowertrapeziustransferatreatmentalgorithmforirreparableposterosuperiorrotatorcufftearsmusclestransfersinposterosuperiorrotatorcufftears AT tilmanheesmd latissimusdorsitransferorlowertrapeziustransferatreatmentalgorithmforirreparableposterosuperiorrotatorcufftearsmusclestransfersinposterosuperiorrotatorcufftears AT laurensallaartmd latissimusdorsitransferorlowertrapeziustransferatreatmentalgorithmforirreparableposterosuperiorrotatorcufftearsmusclestransfersinposterosuperiorrotatorcufftears AT reminerotmd latissimusdorsitransferorlowertrapeziustransferatreatmentalgorithmforirreparableposterosuperiorrotatorcufftearsmusclestransfersinposterosuperiorrotatorcufftears AT arnomackenmd latissimusdorsitransferorlowertrapeziustransferatreatmentalgorithmforirreparableposterosuperiorrotatorcufftearsmusclestransfersinposterosuperiorrotatorcufftears AT geertalexanderbuijzemdphdfebhs latissimusdorsitransferorlowertrapeziustransferatreatmentalgorithmforirreparableposterosuperiorrotatorcufftearsmusclestransfersinposterosuperiorrotatorcufftears AT laurentlafossemd latissimusdorsitransferorlowertrapeziustransferatreatmentalgorithmforirreparableposterosuperiorrotatorcufftearsmusclestransfersinposterosuperiorrotatorcufftears AT thibaultlafossemd latissimusdorsitransferorlowertrapeziustransferatreatmentalgorithmforirreparableposterosuperiorrotatorcufftearsmusclestransfersinposterosuperiorrotatorcufftears |