Erschienen in:
01.06.2010 | Clinical Research
Modified L’Episcopo Tendon Transfers for Irreparable Rotator Cuff Tears: 5-year Followup
verfasst von:
Christian Gerhardt, MD, Lars Lehmann, MD, Sven Lichtenberg, MD, Peter Magosch, MD, Peter Habermeyer, PhD
Erschienen in:
Clinical Orthopaedics and Related Research®
|
Ausgabe 6/2010
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Abstract
Patients with posterosuperior cuff tears lose functional external rotation of the shoulder. Latissimus dorsi and teres major transfer is performed to restore external rotation. Twenty patients with a mean age was 55.8 ± 6 years underwent this procedure and were examined at averages of 24.7 (n = 17) and 70.6 (n = 13) months. Two patients did not improve presumably because of failure of the transfer. The Constant and Murley score increased from 55.6 to 90.4 after 2 years and to 87.9 after 5 years. The mean active flexion increased from 119.4° to 169.3° and reached 170° after 5 years, and mean external rotation increased from 12° to 35°, finally reaching 23°. The grade of cuff arthritis progressed from initially Grade 1 in 17% and Grade 2 in 28% to Grade 2 in 8%, Grade 3 in 69%, and Grade 4 in 15% at final followup. The acromiohumeral distance increased from 4.5 mm to 6 mm and decreased to 3.8 mm after 5 years. Electromyographic analysis showed activity during isometric internal and external rotation in the transferred muscle in all patients. The L’Episcopo procedure can restore shoulder function, but cuff arthropathy may progress.
Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.