Olimpio Galasso1, Matteo Mantovani2, Marco Muraccini2,3, Antonella Berardi2, Massimo De Benedetto4, Nicola Orlando4, Giorgio Gasparini5, Roberto Castricini4. 1. Department of Orthopedic and Trauma Surgery, "Mater Domini" University Hospital, "Magna Græcia" University, V.le Europa (loc. Germaneto), 88100, Catanzaro, Italy. 2. NCS Lab, Via Pola Esterna 4/12, 41012, Carpi, MO, Italy. 3. Department of Electrical, Electronic and Information Engineering, University of Bologna, Viale del Risorgimento, 2, 40136, Bologna, Italy. 4. Division of Orthopedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy. 5. Department of Orthopedic and Trauma Surgery, "Mater Domini" University Hospital, "Magna Græcia" University, V.le Europa (loc. Germaneto), 88100, Catanzaro, Italy. gasparini@unicz.it.
Abstract
PURPOSE: Latissimus dorsi tendon transfer is a surgical option for the treatment of massive irreparable posterosuperior rotator cuff tear. Whether a favourable clinical outcome is due to the latissimus dorsi muscle contraction rather than the passive tenodesis effect remains to be confirmed. The purpose of the current case-control study was to evaluate the shoulder kinematics and latissimus dorsi activation after latissimus dorsi tendon transfer. METHODS: Eighteen patients suffering from irreparable rotator cuff tear that underwent latissimus dorsi tendon transfer and 18 healthy individuals were examined using a 3D kinematic tracking system and electromyography. Active maximal flexion-extension and abduction-adduction of the humerus were measured for the operated and the contralateral shoulder of the patients and the shoulder of healthy individuals to evaluate the range of motion (ROM) and scapulohumeral rhythm. Electromyographic comparison of isometric contraction between the latissimus dorsi of the operated and contralateral shoulder was carried out. RESULTS: After arthroscopic-assisted latissimus dorsi tendon transfer, patients showed comparable flexion and abduction ROM to their asymptomatic contralateral shoulders and to the shoulders of healthy individuals. Significantly higher scapular ROM values were found between the latissimus dorsi tendon transfer side and the shoulders of healthy individuals. While performing external rotation with 0° shoulder abduction, a greater percentage of the electromyographic peak value (p = 0.047) and a higher latissimus dorsi internal/external rotation ratio (p = 0.004) were noted for the transferred muscle in comparison to the contralateral shoulder. CONCLUSION: Although the arthroscopic-assisted latissimus dorsi tendon transfer failed to normalize scapulothoracic joint movements of patients, a functional latissimus flap and a shoulder ROM similar to the contralateral side or the shoulder of healthy individuals can be expected after this procedure in patients with massive irreparable posterosuperior rotator cuff tear. LEVEL OF EVIDENCE: III.
PURPOSE: Latissimus dorsi tendon transfer is a surgical option for the treatment of massive irreparable posterosuperior rotator cuff tear. Whether a favourable clinical outcome is due to the latissimus dorsi muscle contraction rather than the passive tenodesis effect remains to be confirmed. The purpose of the current case-control study was to evaluate the shoulder kinematics and latissimus dorsi activation after latissimus dorsi tendon transfer. METHODS: Eighteen patients suffering from irreparable rotator cuff tear that underwent latissimus dorsi tendon transfer and 18 healthy individuals were examined using a 3D kinematic tracking system and electromyography. Active maximal flexion-extension and abduction-adduction of the humerus were measured for the operated and the contralateral shoulder of the patients and the shoulder of healthy individuals to evaluate the range of motion (ROM) and scapulohumeral rhythm. Electromyographic comparison of isometric contraction between the latissimus dorsi of the operated and contralateral shoulder was carried out. RESULTS: After arthroscopic-assisted latissimus dorsi tendon transfer, patients showed comparable flexion and abduction ROM to their asymptomatic contralateral shoulders and to the shoulders of healthy individuals. Significantly higher scapular ROM values were found between the latissimus dorsi tendon transfer side and the shoulders of healthy individuals. While performing external rotation with 0° shoulder abduction, a greater percentage of the electromyographic peak value (p = 0.047) and a higher latissimus dorsi internal/external rotation ratio (p = 0.004) were noted for the transferred muscle in comparison to the contralateral shoulder. CONCLUSION: Although the arthroscopic-assisted latissimus dorsi tendon transfer failed to normalize scapulothoracic joint movements of patients, a functional latissimus flap and a shoulder ROM similar to the contralateral side or the shoulder of healthy individuals can be expected after this procedure in patients with massive irreparable posterosuperior rotator cuff tear. LEVEL OF EVIDENCE: III.
Entities:
Keywords:
Electromyography; Latissimus dorsi; Magnetic and inertial sensors; Massive irreparable rotator cuff tear; Muscular activity; Shoulder kinematics; Tendon transfer
Authors: Andrea Giovanni Cutti; Andrea Giovanardi; Laura Rocchi; Angelo Davalli; Rinaldo Sacchetti Journal: Med Biol Eng Comput Date: 2007-12-18 Impact factor: 2.602
Authors: A G Cutti; I Parel; M Raggi; E Petracci; A Pellegrini; A P Accardo; R Sacchetti; G Porcellini Journal: J Biomech Date: 2014-01-13 Impact factor: 2.712