Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Latissimus Dorsi Tendon Transfer With Acromial Osteotomy for Massive Irreparable Rotator Cuff Tear.

ABSTRACT: Latissimus dorsi tendon transfer is an effective option for young and active patients with massive irreparable posterosuperior rotator cuff tears and intact subscapularis tendon. This approach has been shown to relieve pain and improve shoulder function in both the short and long term. We describe a surgical technique using an acromial osteotomy to better expose the greater tuberosity for the tendon transfer without disrupting the deltoid muscle. The latissimus dorsi tendon is reinforced with a human dermal collagen matrix (GraftJacket; Wright Medical Group) for additional augmentation of the muscle to gain more excursion for the tendon transfer to the greater tuberosity. The transferred tendon is fixed to the supraspinatus and infraspinatus footprints on the greater tuberosity using suture anchors. The acromial osteotomy is repaired back anatomically with several No. 5 braided sutures (FiberWire; Arthrex).

SUBMITTER: Pagani NR

PROVIDER: S-EPMC5850886 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Latissimus Dorsi Tendon Transfer With Acromial Osteotomy for Massive Irreparable Rotator Cuff Tear.

Pagani Nicholas R NR Cusano Antonio A Li Xinning X

Arthroscopy techniques 20180108 2

Latissimus dorsi tendon transfer is an effective option for young and active patients with massive irreparable posterosuperior rotator cuff tears and intact subscapularis tendon. This approach has been shown to relieve pain and improve shoulder function in both the short and long term. We describe a surgical technique using an acromial osteotomy to better expose the greater tuberosity for the tendon transfer without disrupting the deltoid muscle. The latissimus dorsi tendon is reinforced with a ...[more]

PMID: 29552476

Similar Datasets

Latissimus dorsi tendon transfer for irreparable rotator cuff tears: a modified technique using arthroscopy.

Project description:Latissimus dorsi transfer is a well-established method for the treatment of posterosuperior massive irreparable rotator cuff tears. We propose using an arthroscopically assisted technique that avoids insult to the deltoid. With the patient in the lateral decubitus position, an L-shaped incision is made along the anterior belly of the latissimus muscle and then along the posterior axillary line. The latissimus and teres major are identified and separated. The tendon insertion of the latissimus is isolated, and a FiberWire traction suture (Arthrex, Naples, FL) is placed, facilitating dissection of the muscle to the thoracodorsal neurovascular pedicle and subsequent mobilization. The interval deep to the deltoid and superficial to the teres minor is developed into a subdeltoid tunnel for arthroscopic tendon transfer. The latissimus tendon is then transferred and stabilized arthroscopically to the lateral aspect of the infraspinatus and supraspinatus footprints by multiple suture anchors.

| S-EPMC3678602 | biostudies-literature

Arthroscopic-Assisted Anterior Latissimus Dorsi Transfer for Irreparable Anterior Rotator Cuff Tear: A Technical Note.

Project description:Several reconstruction techniques for irreparable tears of the subscapularis tendon have been described with variable results regarding pain relief, functional recovery, and dynamic stabilization of the glenohumeral joint. Because of a more advantageous direction of movement compared with previously described transfer techniques such as transfer of the pectoralis major and pectoralis minor tendons, the anterior latissimus dorsi (LD) transfer has been proposed as a potentially beneficial treatment method. This Technical Note aims to introduce an alternative technique for the anterior LD transfer that combines the advantages of a proper muscle release and tendon reinforcement through an axillary incision with the arthroscopic intra-articular and periarticular work, including detachment of the LD tendon from its humeral insertion and reattachment at the lesser tuberosity.

| S-EPMC7917011 | biostudies-literature

Patch-Augmented Latissimus Dorsi Transfer and Open Reduction-Internal Fixation of Unstable Os Acromiale for Irreparable Massive Posterosuperior Rotator Cuff Tear.

Project description:Latissimus dorsi transfer is a reasonable treatment option for massive posterosuperior rotator cuff tears that can substantially improve chronically painful and dysfunctional shoulders. This report and accompanying video describe the treatment of an active 43-year-old man with severe pain and weakness in the right shoulder after 3 failed rotator cuff repairs. Preoperative imaging showed a massive posterosuperior rotator cuff tear retracted to the glenoid as well as a hypermobile os acromiale likely causing dynamic impingement and recurrent rotator cuff tears. After diagnostic arthroscopy, the latissimus tendon is harvested and augmented with a 3-mm human acellular dermal patch (ArthroFlex; Arthrex, Naples, FL). The native rotator cuff tissue is repaired as much as possible, and the latissimus tendon is passed underneath the deltoid and posterior to the teres minor. The patch-augmented tendon is then integrated into a double-row SpeedBridge repair of eight 4.75-mm BioComposite SwiveLock anchors (Arthrex). The bony surface of the os acromiale is prepared and then fixed to the acromion with 2 cannulated partially threaded screws and additional tension-band wiring. Postoperative rehabilitation initially focuses on early passive range of motion, followed by active and active-assisted motion and a biofeedback program starting at 6 weeks postoperatively.

| S-EPMC4662244 | biostudies-literature

Consider Long Head of Biceps Tendon for Reconstruction of Massive, Irreparable Rotator Cuff Tear.

Project description:Despite the different treatment options for irreparable and massive rotator cuff tears (RCTs), there is no optimal treatment. Thirty percent of total RCTs can be classified as irreparable because of the massive tear size and severe muscle atrophy. The reported treatment failure rate is approximately 40% for massive RCTs. RCTs may be treated conservatively or surgically depending on pain, disability, and functional demands. The surgical treatment options are many, but decision making is a challenge; the real challenge is to apply the correct procedure for the correct indication in each patient. The long head of the biceps tendon (LHBT) was used for augmentation to bridge the gap in immobile, massive RCTs. An arthroscopic biceps-incorporating technique was used for repair of large and massive RCTs, avoiding undue tension on the rotator cuff (RC). Recently, the LHBT was used for superior capsular reconstruction. This article describes the use of the LHBT for reconstruction of massive and irreparable RCTs through the following steps: (1) open exposure of the RCT, (2) debridement and subacromial decompression, (3) biceps tenotomy at the LHBT's origin on the glenoid, (4) LHBT and RC cuff mobilization, (5) passage of the LHBT through the mobilized RC and reflection onto itself, (6) tuberoplasty, and (7) fixation of the RC complex at the RC footprint.

| S-EPMC7917143 | biostudies-literature

Arthroscopic-Assisted Pectoralis Minor Transfer for Irreparable Anterosuperior Massive Rotator Cuff Tear.

Project description:An irreparable anterosuperior massive rotator cuff tear with an irreparable subscapularis tear is not common; however, once symptomatic, it would become a challenging situation. Tendon transfer is a choice and the pectoralis major is a commonly selected graft source. However, there are theoretical concerns over its use: high invasiveness and low reproducibility, different force vector from the subscapularis, unsuitability for the arthroscopic modification, and difficulty in conversion to the reverse shoulder arthroplasty due to adhesions and scar formation in the anterior shoulder. Recently, open pectoralis minor transfer has been advocated as an alternative reconstruction option. We describe an arthroscopic-assisted technique of pectoralis minor transfer for irreparable anterosuperior massive rotator cuff tear.

| S-EPMC5989649 | biostudies-literature

Reverse Total Shoulder Arthroplasty for Treatment of Massive, Irreparable Rotator Cuff Tear.

Project description:Massive tears of the rotator cuff can result in severe functional deficits due to loss of the axial force couple and effective fulcrum that the intact cuff normally provides. For massive, irreparable rotator cuff tears, especially in the setting of early to moderate degenerative changes, reverse total shoulder arthroplasty functions to modify the center of joint rotation, allowing the deltoid and intact components of the cuff to carry out shoulder function more effectively. Our preferred technique uses a standard open deltopectoral shoulder approach with a 3-dimensional glenoid baseplate model and a 135° prosthesis in an onlay configuration to reduce the risk of scapular notching and increase lateralization of the humerus.

| S-EPMC9244853 | biostudies-literature

Technical Guide and Tips to Posterior Arthroscopic Latissimus Dorsi Transfer for Irreparable Posterosuperior Rotator Cuff Tears.

Project description:Latissimus dorsi (LD) transfer is a reliable treatment option for irreparable posterosuperior (PS) rotator cuff tears in young and active patients that need to recover the range of motion for their daily living activities. The technique starts with an arthroscopic assessment of the tear. The next step is the mini-open stage for muscle release from the subcutaneous layer of the skin, the teres major (TM), the triceps, and the lateral border and inferior angle of the scapula. Later, the scope is used to prepare the footprint (arthroscopy) and for the release and the harvest of the tendon (endoscopy), taking care not to detach the TM and not to damage the radial nerve. A grasper is used to push the LD to its correct path medial to the triceps. After that the same instrument is placed from the anterolateral and the anterior arthroscopic portals toward the mini-open incision to catch the sutures previously loaded on the LD tendon with Krackow stitches. The LD is transferred to the greater tuberosity and is attached with one medial and one lateral knotless anchors. A third point of fixation enables a partial RC repair and ensures a surface of bone to tendon healing.

| S-EPMC9134106 | biostudies-literature

Long Head Biceps Tendon-Natural Patch for Massive Irreparable Rotator Cuff Tears.

Project description:Despite the development in shoulder surgery, massive irreparable rotator cuff tears still remain challenging for orthopaedic surgeons. Many surgical methods are addressed to this kind of pathology, but each of them has its own limitations. We decided to fuse the ideas of superior capsular reconstruction, "GraftJacket" technique, and partial rotator cuff repair. In this way, the technique using the long head biceps tendon simultaneously as a vascularized bridge between rotator cuff remnants and greater tubercle and as a depressor for the humeral head was created. This Technical Note describes the technique.

| S-EPMC5984293 | biostudies-other

Robotic Transfer of the Latissimus Dorsi for Irreparable Subscapularis Tear.

Project description:This Technical Note presents an endoscopic robotic anterior axillary shoulder approach using of the DaVinci (Intuitive Surgical, Sunnyvale, CA) robot, which allows one to endoscopically access and harvest the latissimus dorsi tendon for occasions in which the patient presents an irreparable lesion of the subscapularis tendon. Harvesting the latissimus dorsi through an anterior axillary approach is specially desirable when one needs to access the anterior portion of the shoulder, as happens for subscapularis irreparable lesions.

| S-EPMC9244639 | biostudies-literature

Rooting Rotator Cuff Reconstruction for Irreparable Posterior-Superior Rotator Cuff Tear.

Project description:Irreparable posterior-superior rotator cuff tear is encountered quite often in clinical practice. Bridging the tendon defect with various materials is reasonable. However, optimal bridging structures and techniques are still being pursued. We introduce a rotator cuff bridging technique, rooting rotator cuff reconstruction. In this technique, autogenous tendon is used to make grafts. On the medial side, the graft tendons are suspended on the rotator cuff tendon. On the lateral side, the graft tendons are placed into tunnels through the tuberosities. The most critical steps of this technique are properly fabricating the humeral tunnels and suspending the graft tendons onto the rotator cuff tendon. We believe this technique will shed light on rotator cuff reconstruction.

| S-EPMC7953171 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data