PMID- 36529382
OWN - NLM
STAT- MEDLINE
DCOM- 20230320
LR  - 20230320
IS  - 1532-6500 (Electronic)
IS  - 1058-2746 (Linking)
VI  - 32
IP  - 4
DP  - 2023 Apr
TI  - Biomechanical comparison of combined latissimus dorsi and teres major tendon 
      transfer vs. latissimus dorsi tendon transfer in shoulders with irreparable 
      anterosuperior rotator cuff tears.
PG  - 703-712
LID - S1058-2746(22)00878-3 [pii]
LID - 10.1016/j.jse.2022.11.007 [doi]
AB  - BACKGROUND: Irreparable anterosuperior rotator cuff tears (IASRCTs) can result in 
      a gradual loss of active elevation and internal rotation, superior and anterior 
      translation of the humeral head, and cuff tear arthropathy. Joint-preserving 
      treatment options for IASRCTs in young and high-demand elderly patients remain a 
      subject of ongoing debate. The aim of the study was to evaluate the biomechanical 
      efficacy of the combined latissimus dorsi and teres major tendon (LDTM) transfer 
      and compare it to an isolated latissimus dorsi (LD) transfer in a cadaveric 
      IASRCT model. METHODS: Eight cadaveric shoulders (mean age, 68.3 +/- 5.2 years; 
      range 58-71) were tested with a custom shoulder testing system. All specimens 
      were tested at 0 degrees , 30 degrees , and 60 degrees  of glenohumeral abduction in the scapular plane 
      under 4 conditions: (1) intact, (2) IASRCT, (3) combined LDTM transfer, and (4) 
      isolated LD transfer. The superior and anteroinferior translation and subacromial 
      contact pressure were measured. The effects of 3 different LD and LDTM muscle 
      loading conditions were investigated to determine the effectiveness of the muscle 
      transfer conditions. A linear mixed effect model was used for statistical 
      analysis, followed by a Tukey post hoc test. RESULTS: IASRCTs significantly 
      increased superior translation, anteroinferior translation, and subacromial peak 
      contact pressure. Combined LDTM transfer significantly decreased superior and 
      anteroinferior translation compared with IASRCTs in all positions and muscle 
      loadings. Isolated LD transfer did not significantly decrease superior (P > .115) 
      and anteroinferior translation (P > .151) compared to IASRCT at any abduction and 
      muscle loads except superior translation at 60 degrees  abduction and 90 degrees  of external 
      rotation (ER) (P < .036). LDTM transfer also significantly decreased peak contact 
      pressure from the IASRCT condition at every abduction angle (P < .046). However, 
      isolated LD transfer significantly decreased subacromial peak contact pressure 
      only at 30 degrees  abduction and 0 degrees  and 30 degrees  of ER with triple loading (P < .048), as 
      well as at 60 degrees  abduction and 90 degrees  of ER (P < .003). CONCLUSIONS: Combined LDTM 
      transfer decreased superior translation, anteroinferior translation, and 
      subacromial contact pressure compared with the IASRCT condition. Isolated LD 
      transfer did not improve glenohumeral translation and subacromial contact 
      pressure. Combined LDTM transfer may be a more reliable treatment option than 
      isolated LD transfer in patients with an IASRCT.
CI  - Copyright (c) 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. 
      Published by Elsevier Inc. All rights reserved.
FAU - Baek, Gyu Rim
AU  - Baek GR
AD  - Orthopedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, 
      USA.
FAU - Kim, Jung Gon
AU  - Kim JG
AD  - Department of Orthopedic Surgery, Yeosu Baek Hospital, Yeosu-si, Jeollanam-do, 
      Republic of Korea.
FAU - Kwak, Daniel
AU  - Kwak D
AD  - Orthopedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, 
      USA.
FAU - Nakla, Andrew P
AU  - Nakla AP
AD  - Orthopedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, 
      USA.
FAU - Chung, Min-Shik
AU  - Chung MS
AD  - Orthopedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, 
      USA.
FAU - McGarry, Michelle H
AU  - McGarry MH
AD  - Orthopedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, 
      USA.
FAU - Lee, Thay Q
AU  - Lee TQ
AD  - Orthopedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, 
      USA. Electronic address: tqlee@congressmedicalfoundation.org.
LA  - eng
PT  - Journal Article
DEP - 20221215
PL  - United States
TA  - J Shoulder Elbow Surg
JT  - Journal of shoulder and elbow surgery
JID - 9206499
SB  - IM
MH  - Humans
MH  - Aged
MH  - Middle Aged
MH  - Shoulder
MH  - *Rotator Cuff Injuries/surgery
MH  - Rotator Cuff/surgery
MH  - Tendon Transfer
MH  - *Superficial Back Muscles
MH  - *Shoulder Joint/surgery
MH  - Tendons
MH  - Cadaver
MH  - Biomechanical Phenomena
MH  - Range of Motion, Articular/physiology
OTO - NOTNLM
OT  - Combined latissimus dorsi and teres major tendon transfer
OT  - anterosuperior rotator cuff tear
OT  - glenohumeral stability
OT  - tendon transfer
EDAT- 2022/12/19 06:00
MHDA- 2023/03/21 06:00
CRDT- 2022/12/18 19:25
PHST- 2022/06/27 00:00 [received]
PHST- 2022/10/26 00:00 [revised]
PHST- 2022/11/10 00:00 [accepted]
PHST- 2022/12/19 06:00 [pubmed]
PHST- 2023/03/21 06:00 [medline]
PHST- 2022/12/18 19:25 [entrez]
AID - S1058-2746(22)00878-3 [pii]
AID - 10.1016/j.jse.2022.11.007 [doi]
PST - ppublish
SO  - J Shoulder Elbow Surg. 2023 Apr;32(4):703-712. doi: 10.1016/j.jse.2022.11.007. 
      Epub 2022 Dec 15.