Skip to main content
Erschienen in: International Orthopaedics 2/2009

01.04.2009 | Original Paper

Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff

verfasst von: Manuel Zafra, Pedro Carpintero, Carmen Carrasco

Erschienen in: International Orthopaedics | Ausgabe 2/2009

Einloggen, um Zugang zu erhalten

Abstract

The objective of this paper was to determine the outcome of the transfer of the latissimus dorsi tendon in patients with massive irreparable rotator cuff tears. Eighteen patients of mean age 54 years (range 37–72 years) with massive irreparable rotator cuff tears were studied. The mean follow-up was 28 months (range 12–58 months). The postoperative Constant score was higher by an average of 21.15 points compared to the preoperative score (P=0.002); 88.8% of patients reported significant pain relief and improved mobility, particularly on external rotation. Postoperative resting antero-posterior radiography in neutral rotation revealed a mean 3.2-mm depression of the humeral head, due to the tenodesis effect of tendon transfer, thus, increasing the deltoid lever arm. These clinical results suggest that latissimus dorsi transfer is a useful surgical technique for treating massive irreparable postero-superior tears of the rotator cuff in young and/or active patients, providing significant pain relief and improved shoulder strength.
Literatur
1.
Zurück zum Zitat Aldridge JM 3rd, Atkinson TS, Mallon WJ (2004) Combined pectoralis major and latissimus dorsi tendon transfer for massive rotator cuff deficiency. J Shoulder Elbow Surg 13:621–629PubMedCrossRef Aldridge JM 3rd, Atkinson TS, Mallon WJ (2004) Combined pectoralis major and latissimus dorsi tendon transfer for massive rotator cuff deficiency. J Shoulder Elbow Surg 13:621–629PubMedCrossRef
2.
Zurück zum Zitat Aoki M, Okamura K, Fukushima S, Takahashi T, Ogino T (1996) Transfer of latissimus dorsi for irreparable rotator-cuff tears. J Bone Joint Surg Br 78:761–766PubMed Aoki M, Okamura K, Fukushima S, Takahashi T, Ogino T (1996) Transfer of latissimus dorsi for irreparable rotator-cuff tears. J Bone Joint Surg Br 78:761–766PubMed
3.
Zurück zum Zitat Apoil A, Augereau B (1985) Réparation par lambeau deltoïdien des grandes pertes de substance de la coiffe des rotateurs de l’éépaule. Chirurgie 111:287–290PubMed Apoil A, Augereau B (1985) Réparation par lambeau deltoïdien des grandes pertes de substance de la coiffe des rotateurs de l’éépaule. Chirurgie 111:287–290PubMed
4.
Zurück zum Zitat Bigliani LU, Cordasco FA, McIlveen SJ, Musso ES (1992) Operative treatment of massive rotator cuff tears: long-term results. J Shoulder Elbow Surg 1:120–130CrossRef Bigliani LU, Cordasco FA, McIlveen SJ, Musso ES (1992) Operative treatment of massive rotator cuff tears: long-term results. J Shoulder Elbow Surg 1:120–130CrossRef
5.
Zurück zum Zitat Burkhart SS (1991) Arthroscopic treatment of massive rotator cuff tears. Clinical results and biomechanical rationale. Clin Orthop Relat Res 267:45–56PubMed Burkhart SS (1991) Arthroscopic treatment of massive rotator cuff tears. Clinical results and biomechanical rationale. Clin Orthop Relat Res 267:45–56PubMed
6.
Zurück zum Zitat Celli L, Rovesta C, Marongiu MC, Manzieri S (1998) Transplantation of teres major muscle for infraspinatus muscle in irreparable rotator cuff tears. J Shoulder Elbow Surg 7:485–490PubMedCrossRef Celli L, Rovesta C, Marongiu MC, Manzieri S (1998) Transplantation of teres major muscle for infraspinatus muscle in irreparable rotator cuff tears. J Shoulder Elbow Surg 7:485–490PubMedCrossRef
7.
Zurück zum Zitat Cofield RH, Parvizi J, Hoffmeyer PJ, Lanzer WL, Ilstrup DM, Rowland CM (2001) Surgical repair of chronic rotator cuff tears. A prospective long-term study. J Bone Joint Surg Am 83:71–77PubMed Cofield RH, Parvizi J, Hoffmeyer PJ, Lanzer WL, Ilstrup DM, Rowland CM (2001) Surgical repair of chronic rotator cuff tears. A prospective long-term study. J Bone Joint Surg Am 83:71–77PubMed
8.
Zurück zum Zitat Constant CR, Murley AGH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164PubMed Constant CR, Murley AGH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164PubMed
9.
Zurück zum Zitat Fenlin JM Jr, Chase JM, Rushton SA, Frieman BG (2002) Tuberoplasty: creation of an acromiohumeral articulation—a treatment option for massive, irreparable rotator cuff tears. J Shoulder Elbow Surg 11:136–142PubMedCrossRef Fenlin JM Jr, Chase JM, Rushton SA, Frieman BG (2002) Tuberoplasty: creation of an acromiohumeral articulation—a treatment option for massive, irreparable rotator cuff tears. J Shoulder Elbow Surg 11:136–142PubMedCrossRef
10.
Zurück zum Zitat Gartsman GM (1995) Arthroscopic treatment of rotator cuff disease. J Shoulder Elbow Surg 4:228–241PubMedCrossRef Gartsman GM (1995) Arthroscopic treatment of rotator cuff disease. J Shoulder Elbow Surg 4:228–241PubMedCrossRef
11.
Zurück zum Zitat Gerber C (1992) Latissimus dorsi transfer for the treatment of irreparable tears of the rotator cuff. Clin Orthop Relat Res 275:152–160PubMed Gerber C (1992) Latissimus dorsi transfer for the treatment of irreparable tears of the rotator cuff. Clin Orthop Relat Res 275:152–160PubMed
12.
Zurück zum Zitat Gerber C, Vinh TS, Hertel R, Hess CW (1988) Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff: a preliminary report. Clin Orthop Relat Res 232:51–61PubMed Gerber C, Vinh TS, Hertel R, Hess CW (1988) Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff: a preliminary report. Clin Orthop Relat Res 232:51–61PubMed
13.
Zurück zum Zitat Goutallier D, Bernargeau J, Patte D (1989) L’évaluation par le scanner de la trophicité des muscles de la coiffe des rotateurs ayant una rupture tendineuse. Rev Chir Orthop 75(Suppl 1):126–127 Goutallier D, Bernargeau J, Patte D (1989) L’évaluation par le scanner de la trophicité des muscles de la coiffe des rotateurs ayant una rupture tendineuse. Rev Chir Orthop 75(Suppl 1):126–127
14.
Zurück zum Zitat Gumina S, Di Giorgio G, Perugia D, Postacchini F (2008) Deltoid detachment consequent to open surgical repair of massive rotator cuff tears. Int Orthop 32:81–84PubMedCrossRef Gumina S, Di Giorgio G, Perugia D, Postacchini F (2008) Deltoid detachment consequent to open surgical repair of massive rotator cuff tears. Int Orthop 32:81–84PubMedCrossRef
15.
Zurück zum Zitat Miniaci A, MacLeod M (1999) Transfer of the latissimus dorsi muscle after failed repair of a massive tear of the rotator cuff. A two to five-year review. J Bone Joint Surg Am 81:1120–1127PubMed Miniaci A, MacLeod M (1999) Transfer of the latissimus dorsi muscle after failed repair of a massive tear of the rotator cuff. A two to five-year review. J Bone Joint Surg Am 81:1120–1127PubMed
16.
Zurück zum Zitat Pagnotta A, Haerle M, Gilbert A (2004) Long-term results on abduction and external rotation of the shoulder after latissimus dorsi transfer for sequelae of obstetric palsy. Clin Orthop Relat Res 426:199–205PubMedCrossRef Pagnotta A, Haerle M, Gilbert A (2004) Long-term results on abduction and external rotation of the shoulder after latissimus dorsi transfer for sequelae of obstetric palsy. Clin Orthop Relat Res 426:199–205PubMedCrossRef
17.
Zurück zum Zitat Rockwood CA, Williams GR, Burkhead WZ (1995) Debridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg Am 77:857–866PubMed Rockwood CA, Williams GR, Burkhead WZ (1995) Debridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg Am 77:857–866PubMed
18.
Zurück zum Zitat Tempelhof S, Rupp S, Seil R (1999) Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg 8:296–299PubMedCrossRef Tempelhof S, Rupp S, Seil R (1999) Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg 8:296–299PubMedCrossRef
19.
Zurück zum Zitat Vandenbussche E, Bensaïda M, Mutschler C, Dart T, Augereau B (2004) Massive tears of the rotator cuff treated with a deltoid flap. Int Orthop 28:226–230PubMedCrossRef Vandenbussche E, Bensaïda M, Mutschler C, Dart T, Augereau B (2004) Massive tears of the rotator cuff treated with a deltoid flap. Int Orthop 28:226–230PubMedCrossRef
20.
Zurück zum Zitat Walch G, Madonia G, Pozzi I, Riand N, Lévigne C (1997) Arthroscopic tenotomy of the tendon of the long head of the biceps in rotator cuff ruptures. In: Gazielly D, Gleyze P, Thomas T (eds) The cuff. Elsevier, Amsterdam, pp 350–355 Walch G, Madonia G, Pozzi I, Riand N, Lévigne C (1997) Arthroscopic tenotomy of the tendon of the long head of the biceps in rotator cuff ruptures. In: Gazielly D, Gleyze P, Thomas T (eds) The cuff. Elsevier, Amsterdam, pp 350–355
21.
Zurück zum Zitat Warner JJP (2001) Management of massive irreparable rotator cuff tears: the role of tendon transfer. Instr Course Lect 50:63–71PubMed Warner JJP (2001) Management of massive irreparable rotator cuff tears: the role of tendon transfer. Instr Course Lect 50:63–71PubMed
22.
Zurück zum Zitat Warner JJP, Parsons IM 4th (2001) Latissimus dorsi tendon transfer: a comparative analysis of primary and salvage reconstruction of massive, irreparable rotator cuff tears. J Shoulder Elbow Surg 10:514–521PubMedCrossRef Warner JJP, Parsons IM 4th (2001) Latissimus dorsi tendon transfer: a comparative analysis of primary and salvage reconstruction of massive, irreparable rotator cuff tears. J Shoulder Elbow Surg 10:514–521PubMedCrossRef
23.
Zurück zum Zitat Yamaguchi K (2001) Mini-open rotator cuff repair: an updated perspective. Instr Course Lect 50:53–61PubMed Yamaguchi K (2001) Mini-open rotator cuff repair: an updated perspective. Instr Course Lect 50:53–61PubMed
24.
Zurück zum Zitat Yamaguchi K, Sher JS, Andersen WK, Garretson R, Uribe JW, Hechtman K, Neviaser RJ (2000) Glenohumeral motion in patients with rotator cuff tears: a comparison of asymptomatic and symptomatic shoulders. J Shoulder Elbow Surg 9:6–11PubMedCrossRef Yamaguchi K, Sher JS, Andersen WK, Garretson R, Uribe JW, Hechtman K, Neviaser RJ (2000) Glenohumeral motion in patients with rotator cuff tears: a comparison of asymptomatic and symptomatic shoulders. J Shoulder Elbow Surg 9:6–11PubMedCrossRef
Metadaten
Titel
Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff
verfasst von
Manuel Zafra
Pedro Carpintero
Carmen Carrasco
Publikationsdatum
01.04.2009
Verlag
Springer-Verlag
Erschienen in
International Orthopaedics / Ausgabe 2/2009
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-008-0536-9

Weitere Artikel der Ausgabe 2/2009

International Orthopaedics 2/2009 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.