دورية أكاديمية

Long-term outcomes of anterior latissimus dorsi tendon transfer for irreparable subscapularis tears.

التفاصيل البيبلوغرافية
العنوان: Long-term outcomes of anterior latissimus dorsi tendon transfer for irreparable subscapularis tears.
المؤلفون: Baek CH; Department of Orthopaedic Surgery, Yeosu Baek Hospital, Jeollanam-do, South Korea., Kim JG; Department of Orthopaedic Surgery, Yeosu Baek Hospital, Jeollanam-do, South Korea., Kim BT; Department of Orthopaedic Surgery, Yeosu Baek Hospital, Jeollanam-do, South Korea.
المصدر: The bone & joint journal [Bone Joint J] 2024 Sep 01; Vol. 106-B (9), pp. 957-963. Date of Electronic Publication: 2024 Sep 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: British Editorial Society of Bone & Joint Surgery Country of Publication: England NLM ID: 101599229 Publication Model: Electronic Cited Medium: Internet ISSN: 2049-4408 (Electronic) Linking ISSN: 20494394 NLM ISO Abbreviation: Bone Joint J Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : British Editorial Society of Bone & Joint Surgery
مواضيع طبية MeSH: Tendon Transfer*/methods , Rotator Cuff Injuries*/surgery , Range of Motion, Articular* , Superficial Back Muscles*/transplantation, Humans ; Male ; Retrospective Studies ; Female ; Middle Aged ; Aged ; Treatment Outcome ; Adult ; Follow-Up Studies ; Shoulder Joint/surgery ; Shoulder Joint/physiopathology ; Tendon Injuries/surgery ; Rotator Cuff/surgery
مستخلص: Aims: Favourable short-term outcomes have been reported following latissimus dorsi tendon transfer for patients with an irreparable subscapularis (SSC) tendon tear. The aim of this study was to investigate the long-term outcomes of this transfer in these patients.
Methods: This was a retrospective study involving 30 patients with an irreparable SSC tear and those with a SSC tear combined with a reparable supraspinatus tear, who underwent a latissimus dorsi tendon transfer. Clinical scores and active range of motion (aROM), SSC-specific physical examination and the rate of return to work were assessed. Radiological assessment included recording the acromiohumeral distance (AHD), the Hamada grade of cuff tear arthropathy and the integrity of the transferred tendon. Statistical analysis compared preoperative, short-term (two years), and final follow-up at a mean of 8.7 years (7 to 10).
Results: There were significant improvements in clinical scores, in the range and strength of internal rotation and aROM compared with the preoperative values in the 26 patients (87%) who were available for long-term follow-up. These improvements were maintained between short- and long-term follow-ups. Although there was a decreased mean AHD of 7.3 mm (SD 1.5) and an increased mean Hamada grade of 1.7 (SD 0.5) at final follow-up, the rate of progression of cuff tear arthropathy remained low-grade. Comparison between the isolated SSC and combined SSC and reparable supraspinatus tear groups showed no significant differences. At final follow-up, one patient (3.8%) had undergone revision surgery to a reverse shoulder arthroplasty (RSA). No neurological complications were associated with the procedure.
Conclusion: Latissimus dorsi transfer for an irreparable SSC tendon tear resulted in a significant clinical improvement, particularly in pain, range and strength of internal rotation and aROM, which were maintained over a mean of 8.7 years following surgery. Given that this was a long-term outcome study, there was a low-grade progression in the rate of cuff tear arthropathy. Thus, the long-term clinical efficacy of latissimus dorsi tendon transfer in patients with irreparable SSC was confirmed as a joint-preserving procedure for these patients, suggesting it as an effective alternative to RSA in young, active patients without degenerative changes of the glenohumeral joint.
Competing Interests: None declared.
(© 2024 The British Editorial Society of Bone & Joint Surgery.)
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تواريخ الأحداث: Date Created: 20240831 Date Completed: 20240831 Latest Revision: 20240831
رمز التحديث: 20240902
DOI: 10.1302/0301-620X.106B9.BJJ-2024-0099.R1
PMID: 39216861
قاعدة البيانات: MEDLINE
الوصف
تدمد:2049-4408
DOI:10.1302/0301-620X.106B9.BJJ-2024-0099.R1