Shoulder Joint Impairment
Arthroscopic lattisimus dorsi transfer with rotator cuff repair for posterosuperior irreparable massive rotator cuff tear
Sun Yaying, Chen Jiwu, Shang Xiliang, Li Hong, Chen Shiyi, Li Yunxia, Liu Shaohua
Published 2017-11-01
Cite as Chin J Orthop, 2017,37(21): 1326-1332. DOI: 10.3760/cma.j.issn.0253-2352.2017.21.003
Abstract
ObjectiveTo discuss the effect of arthroscopic latissimus dorsi transfer with rotator cuff repair for posterosu-perior irreparable massive rotator cuff tear (iMRCT).
MethodsFrom September 2014 to December 2015, data of 13 iMRCT including 4 male and 9 female who underwent arthroscopic latissimus dorsi transfer with rotator cuff repair were retrospectively analyzed. The age was ranged from 54 to 65, with a mean age of 58.5±4.3. The mean duration of symptom was 2.1±0.6 years. During operation, complete or partial rotator cuff repair was performed, followed by complete repair of injured subscapularis tendon and tenotomy or tenodesis of the long head of biceps tendon. An arc incision was then made in the axillary fossa to harvest latissimus dorsi tendon from its humeral insertion. The tendon was then introduced into subacromial space and fixed at the footprint of greater tuberosity arthroscopically. X-ray and MRI were conducted prior to and one day after the surgery and at the last follow-up. Pain visual analog scale (VAS) and active range of motion in all planes as well as Constant-Murley score and Fudan University shoulder score (FUSS) were documented before the surgery and at the last follow-up.
ResultsAll 13 patients accomplished the follow-up, with a duration from 17 to 22 months and a mean period of 19.6±0.9 months. No complications occurred. No re-tear was identified. The mean acromiohumeral distance increased from 5.4±1.1 mm to 7.0±0.6 mm. The mean VAS decreased from 4.8±1.3 to 0.5±0.7. The mean 0° abduction external rotation, 90° abduction external rotation, flexion, as well as abduction increased from 17.3°±10.5°, 12.4°±7.8°, 89.2°±41.2°, 87.3°±40.7° to 41.2°±12.5°, 56.5°±16.6°, 120.5°±25.1°, and 113.5°±25.4° respectively. Constant-Murley score and FUSS increased from 33.5±9.9 and 50.9±7.6 to 62.8±8.1, and 81.7±7.0, respectively. The improvement in all measurements was significant.
ConclusionFor posterosuperior iMRCT, arthroscopic latissimus dorsi transfer with rotator cuff repair can decrease shoulder pain and improve shoulder function.
Key words:
Shoulder joint; Arthroscopy; Soft tissue injuries
Contributor Information
Sun Yaying
Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
Chen Jiwu
Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
Shang Xiliang
Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
Li Hong
Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
Chen Shiyi
Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
Li Yunxia
Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
Liu Shaohua
Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
