KMID : 1036220190220010009
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Clinics in Shoulder and Elbow 2019 Volume.22 No. 1 p.9 ~ p.15
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Arthroscopic-assisted Latissimus Dorsi Tendon Transfer for the Management of Irreparable Rotator Cuff Tears in Middle-aged Physically Active Patients
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Lim Tae-Kang
Bae Kyu-Hwan
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Abstract
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Background: Latissimus dorsi (LD) tendon transfer is used as a treatment option for massive irreparable posterosuperior rotator cuff tears, and recently, an arthroscopic-assisted technique was introduced. This study was undertaken to evaluate the clinical and radiological outcomes of arthroscopic-assisted LD tendon transfer for the management of irreparable rotator cuff tears in active middle-aged patients.
Methods: The records of five patients (two males) with irreparable tears involving the supraspinatus and infraspinatus tendons managed by arthroscopic-assisted LD tendon transfer were retrospectively reviewed. Clinical outcomes were assessed using the visual analogue scale (VAS) pain scale, American Shoulder and Elbow Surgeon¡¯s (ASES) scores, the University of California Los Angeles (UCLA) scale, and ranges of motion. Postoperative integrities of transferred tendon were evaluated by magnetic resonance imaging in 4 patients and by ultrasound in one.
Results: Mean patient age was 55 years (range, 48?61 years), and mean follow-up period was 20 months (range, 12.0?27.2 months). Mean VAS score significantly improved from 6.6 ¡¾ 2.6 preoperatively to 1.8 ¡¾ 2.5 postoperatively (p=0.009), mean ASES score increased from 67.6 ¡¾ 9.2 to 84.6 ¡¾ 15.1, and mean UCLA score from 18.0 ¡¾ 1.4 to 28.8 ¡¾ 8.5 (all p<0.001). Postoperative imaging of the transferred LD tendon showed intact repair in 4 patients. The remaining patient experienced LD transfer rupture and a poor outcome.
Conclusions: Arthroscopic-assisted LD tendon transfer improved shoulder pain and function in patients with massive, irreparable rotator cuff tears, and may be an option for this condition, especially in physically active patients.
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KEYWORD
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Irreparable, Rotator cuff tear, Latissimus dorsi, Arthroscopic, Tendon transfer
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