Jean Kany1, Padmanaban Sekaran2, Jean Grimberg3, Rajkumar S Amavarathi4, Philippe Valenti5, Bassem Elhassan6, Jean David Werthel7. 1. Shoulder Department, Clinique de l'Union, Ramsay GDS, Saint Jean, France. Electronic address: jean.kany@clinique-union.fr. 2. Lakshmi Hospital, Ernakulam, Kerala, India. 3. Shoulder Department, LIRCOS, Clinique Jouvenet, Ramsay GDS, Paris, France. 4. Division of Arthroscopy and Sports Surgery, Department of Orthopaedics, St John's Medical College and Hospital, Bangalore, Karnataka, India. 5. Shoulder Department, Clinique Bizet, Paris, France. 6. Shoulder Department, Mayo Clinic, Rochester, MN, USA. 7. Shoulder Department, Hôpital Ambroise Pare, Paris, France.
Abstract
BACKGROUND: To compare latissimus dorsi tendon rupture rates after arthroscopic transfer for posterior superior rotator cuff tear using 3 different humeral head fixation techniques. METHODS: One-hundred fifty consecutive latissimus dorsi transfers were included. Inclusion criteria were massive irreparable posterosuperior rotator cuff tear with advanced fatty infiltration associated with persistent pain and limited range of motion after failed conservative treatments or surgery. All transfers were arthroscopically assisted and fixed in a transosseous tunnel with a cortical button (group 1, n = 59), "over the top" onto the footprint of the supraspinatus (group 2, n = 47), or posteriorly onto the footprint of the infraspinatus (group 3, n = 44) with 2 suture anchors. The tendons were marked with 3 metallic clips placed intraoperatively at a fixed distance of 2, 4, and 6 cm from the tip. Immediate postoperative standard anteroposterior radiographs were performed to confirm the position of the clips and to determine whether the clips displaced on subsequent radiographs during follow-up, indicating tendon rupture. RESULTS: Repeat radiographs at 3-month follow-up showed higher risk of latissimus dorsi transfer rupture rate in 27/59 patients in group 1 (46%), 11/47 in group 2 (24%), and 7/44 in group 3 (15%). CONCLUSION: Posterior anchor fixation of the latissimus dorsi tendon onto the infraspinatus footprint had the lowest rupture rate.
BACKGROUND: To compare latissimus dorsi tendon rupture rates after arthroscopic transfer for posterior superior rotator cuff tear using 3 different humeral head fixation techniques. METHODS: One-hundred fifty consecutive latissimus dorsi transfers were included. Inclusion criteria were massive irreparable posterosuperior rotator cuff tear with advanced fatty infiltration associated with persistent pain and limited range of motion after failed conservative treatments or surgery. All transfers were arthroscopically assisted and fixed in a transosseous tunnel with a cortical button (group 1, n = 59), "over the top" onto the footprint of the supraspinatus (group 2, n = 47), or posteriorly onto the footprint of the infraspinatus (group 3, n = 44) with 2 suture anchors. The tendons were marked with 3 metallic clips placed intraoperatively at a fixed distance of 2, 4, and 6 cm from the tip. Immediate postoperative standard anteroposterior radiographs were performed to confirm the position of the clips and to determine whether the clips displaced on subsequent radiographs during follow-up, indicating tendon rupture. RESULTS: Repeat radiographs at 3-month follow-up showed higher risk of latissimus dorsi transfer rupture rate in 27/59 patients in group 1 (46%), 11/47 in group 2 (24%), and 7/44 in group 3 (15%). CONCLUSION: Posterior anchor fixation of the latissimus dorsi tendon onto the infraspinatus footprint had the lowest rupture rate.
Authors: Felipe Reinares; Andres Calvo; Nazira Bernal; Pedro Lizama; Philippe Valenti; Felipe Toro Journal: Eur J Orthop Surg Traumatol Date: 2021-06-03
Authors: Alberto Naoki Miyazaki; Caio Santos Checchia; João Manoel Fonseca Filho; João Roberto Polydoro Rosa; Guilherme do Val Sella; Luciana Andrade da Silva Journal: Rev Bras Ortop (Sao Paulo) Date: 2021-03-31