Assessment of the effectiveness of surgical treatment of patients with massive tears of the rotator cuff tendons using arthroscopically assisted transposition of the latissimus dorsi tendon
https://doi.org/10.29413/ABS.2023-8.5.14
Abstract
Rotator cuff tears are one of the most common musculoskeletal injuries and account for about 20 %. Massive rotator cuff tears account for up to 40 % of all tears. There is no single approach in the treatment of patients with massive rotator cuff tears. We have developed a new method of surgical treatment of these patients – arthroscopically assisted transposition of the latissimus dorsi tendon using 1/2 of the tendon of the long peroneal muscle.
The aim of the study. To assess the effectiveness of surgical treatment of patients with massive rotator cuff tears who had arthroscopically assisted transposition of the latissimus dorsi tendon using an autograft of a 1/2 of the tendon of the long peroneal muscle.
Materials and methods. The study included 15 patients with Patte stage III and Thomazeau grade 2–3 massive rotator cuff tears, who had arthroscopically assisted transposition of the latissimus dorsi tendon using 1/2 of the tendon of the long peroneal muscle.
Results. The article presents the long-term results of surgical treatment of patients using the developed method. The following criteria were evaluated: average age; time since injury; duration of surgery. Functional outcome was assessed using the ASES (American Shoulder and Elbow Surgeons) scale. Taking into account the indicators on the ASES functional scale 1 year after surgical treatment, the following results were obtained: excellent – in 14 (93.3 %) patients, satisfactory – in 1 (6.7 %) patient.
Conclusion. The developed method allows us to restore the function of the shoulder joint as early as it possible, to reduce the severity of the pain syndrome and to improve the quality of life of patients.
About the Authors
D. V. MenshovaRussian Federation
Darya V. Menshova – Postgraduate
Bortsov Revolyutsii str. 1, Irkutsk 664003
N. S. Ponomarenko
Russian Federation
Nikolay S. Ponomarenko – Cand. Sc. (Med.), Senior Research Officer at the Clinical Research Department of Traumatology
Bortsov Revolyutsii str. 1, Irkutsk 664003
I. A. Kuklin
Russian Federation
Igor A. Kuklin – Dr. Sc. (Med.), Leading Research Officer at the Clinical Research Department of Traumatology
Bortsov Revolyutsii str. 1, Irkutsk 664003
N. V. Tishkov
Russian Federation
Nikolay V. Tishkov – Cand. Sc. (Med.), Docent, Head of the Clinical Research Department of Traumatology
Bortsov Revolyutsii str. 1, Irkutsk 664003
M. E. Puseva
Russian Federation
Marina E. Puseva – Cand. Sc. (Med.), Head of the Traumatology and Orthopedics Unit No 1
Bortsov Revolyutsii str. 1, Irkutsk 664003
References
1. Yamamoto A, Takagishi K, Osawa T, Yanagawa T, Nakajima D, Shitara H, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elb Surg. 2010; 19: 116-120. doi: 10.1016/j.jse.2009.04.006
2. Kucirek NK, Hung NJ, Wong SE. Treatment options for massive irreparable rotator cuff tears. Curr Rev Musculoskelet Med. 2021; 14(5): 304-315. doi: 10.1007/s12178-021-09714-7
3. Di Benedetto P, Mancuso F, Tosolini L, Buttironi MM, Beltrame A, Causero A. Treatment options for massive rotator cuff tears: A narrative review. Acta Biomed. 2021; 92(S3): e2021026. doi: 10.23750/abm.v92iS3.11766
4. Dunn WR, Kuhn JE, Sanders R, An Q, Baumgarten KM, Bishop JY, et al. Symptoms of pain do not correlate with rotator cuff tear severity. J Bone Joint Surg Am. 2014; 96: 793-800. doi: 10.2106/JBJS.L.01304
5. Dokolin SYu, Kuzmina VI, Naida DA. Surgical correction of vertical instability of the humeral head in patients with arthropathy secondary to massive rotator cuff tears. Opinion Leader. 2018; 4(12): 66-72. (In Russ.).
6. Denard PJ, Brady PC, Adams CR, Tokish JM, Burkhart SS. Preliminary results of arthroscopic superior capsule reconstruction with dermal allograft. Arthroscopy. 2018; 34(1): 93-99. doi: 10.1016/j.arthro.2017.08.265
7. Lee SJ, Min YK. Can inadequate acromiohumeral distance improvement and poor posterior remnant tissue be the predictive factors of re-tear? Preliminary 272 outcomes of arthroscopic superior capsular reconstruction. Knee Surg Sport Traumatol Arthrosc. 2018; 26(7): 2205-2213.
8. Jordan RW, Sharma N, Daggett M, Saithna A. The role of superior capsule reconstruction in the irreparable rotator cuff tear – A systematic review. Orthop Traumatol Surg Res. 2019; 105(8): 1535-1542. doi: 10.1016/j.otsr.2019.07.022
9. Menshova DV, Ponomarenko NS, Kuklin IA, Monastyrev VV, Puseva ME, Balzhinimaev DB. Method for treatment of massive tears of the rotator cuff tendons: Patent No. 2779219 of the Russian Federation. 2022. (In Russ.).
10. Gervasi E, Cautero E, Dekel A. Fluoroscopy-guided implantation of subacromial “biodegradable spacer” using local anesthesia in patients with irreparable rotator cuff tear. Rthrosc Tech. 2014; 3(4): e455-e458. doi: 10.1016/j.eats.2014.05.010
11. Savarese E, Romeo R. New solution for massive, irreparable rotator cuff tears: The subacromial “biodegradable spacer”. Arthrosc Tech. 2012; 1(1): e69-e74. doi: 10.1016/j.eats.2012.02.002
12. Gerber C, Vinh TS, Hertel R, Hess CW. Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff. A preliminary report. Clin Orthop Relat Res. 1988; (232): 51-61.
13. Shea KP, Obopilwe E, Sperling JW, Iannotti JP. A biomechanical analysis of gap formation and failure mechanics of a xenograftreinforced rotator cuff repair in a cadaveric model. J Shoulder Elbow Surg. 2012; 21: 1072-1079. doi: 10.1016/j.jse.2011.07.024
14. Memon M, Kay J, Quick E, Simunovic N, Duong A, Henry P, et al. Arthroscopic-assisted latissimus dorsi tendon transfer for massive rotator cuff tears: A systematic review. Orthop J Sports Med. 2018; 6(6): 2325967118777735. doi: 10.1177/2325967118777735
15. Miyazaki AN, Checchia CS, de Castro Lopes W, Fonseca Filho JM, Sella GDV, da Silva LA. Latissimus dorsi tendon transfer using tendinous allograft for irreparable rotator cuff lesions: surgical technique. Rev Bras Ortop (Sao Paulo). 2019; 54(1): 99-103. doi: 10.1055/s-0038-1676989
16. Ek ET, Neukom L, Catanzaro S, Gerber C. Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: Results after five to fifteen years. J Shoulder Elbow Surg. 2013; 22(9): 1199-1208. doi: 10.1016/j.jse.2012.11.016
17. Van der Zwaal P, Thomassen BJ, Nieuwenhuijse MJ, Lindenburg R, Swen JW, van Arkel ER. Clinical outcome in allarthroscopic versus mini-open rotator cuff repair in small to medium-sized tears: A randomized controlled trial in 100 patients with 1-year follow-up. Arthroscopy. 2013; 29(2): 266-273. doi: 10.1016/j.arthro.2012.08.022
Review
For citations:
Menshova D.V., Ponomarenko N.S., Kuklin I.A., Tishkov N.V., Puseva M.E. Assessment of the effectiveness of surgical treatment of patients with massive tears of the rotator cuff tendons using arthroscopically assisted transposition of the latissimus dorsi tendon. Acta Biomedica Scientifica. 2023;8(5):133-143. https://doi.org/10.29413/ABS.2023-8.5.14