Latissimus dorsi and teres major tendon transfer for irreparable anterosuperior rotator cuff tear improves kinematics and internal rotation compared to latissimus dorsi tendon transfer.
Internal rotation
Irreparable rotator cuff
Kinematics
Latissimus dorsi
Tendon transfer
Teres major
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
15
09
2022
accepted:
11
12
2022
medline:
31
7
2023
pubmed:
20
1
2023
entrez:
19
1
2023
Statut:
ppublish
Résumé
Latissimus dorsi and teres major (LDTM) tendon transfer has demonstrated better clinical outcomes compared to Latissimus dorsi (LD) transfer for irreparable anterosuperior cuff (subscapularis/supraspinatus) tears; however, the biomechanical effects of these procedures are unknown. Therefore, the objective of this study was to compare kinematics and internal rotation of LDTM transfer to LD transfer for anterosuperior cuff tear. Eight cadaveric shoulders were tested in four conditions; (1) intact, (2) anterosuperior rotator cuff tear, (3) LDTM transfer, and (4) LD transfer. Glenohumeral kinematics and internal rotation at 0°, 30°, and 60° of glenohumeral abduction in the scapular plane were measured. Muscle loading was applied based on physiological cross-sectional area ratios with three muscle loading conditions to simulate potentially increased tension due to the advanced insertion site of the transferred tendons. The anterosuperior rotator cuff tear leads to a significant superior shift of the humeral head compared to intact at 0° and 30° abduction (p < 0.039). Both the LDTM (p < 0.047) and LD transfers (p < 0.032) significantly shifted the humeral head inferiorly compared to the tear condition.; however, the LDTM transfer shifted the head in the anteroinferior direction compared to the LD transfer at 60° abduction and 30° ER (p < 0.045). Both LDTM and LD transfer significantly increased internal resting rotation (p < 0.008) and maximum internal rotation (p < 0.008) compared to anterosuperior rotator cuff tear and intact at 30° and 60° abduction. LDTM transfer resulted in a significant internal resting rotation compared with the LD transfer at 30° abduction with double muscle loading (p = 0.02). At 0° abduction, the LDTM transfer (p < 0.027) significantly increased maximum internal rotation compared to anterosuperior rotator cuff tear and intact. Although both LDTM and LD tendon transfer improved the abnormal humeral head apex position and internal rotation compared with the tear condition, the LDTM transfer was biomechanically superior to the LD transfer in a cadaveric model.
Identifiants
pubmed: 36658364
doi: 10.1007/s00402-022-04735-4
pii: 10.1007/s00402-022-04735-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4731-4739Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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