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Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears.
Miyazaki, Alberto Naoki; Checchia, Caio Santos; Fonseca Filho, João Manoel; Rosa, João Roberto Polydoro; Val Sella, Guilherme do; Silva, Luciana Andrade da.
Afiliação
  • Miyazaki AN; Grupo de Cirurgia em Ombro e Cotovelo, Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil.
  • Checchia CS; Grupo de Cirurgia em Ombro e Cotovelo, Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil.
  • Fonseca Filho JM; Grupo de Cirurgia em Ombro e Cotovelo, Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil.
  • Rosa JRP; Departamento de Cirurgia Ortopédica, Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brasil.
  • Val Sella GD; Grupo de Cirurgia em Ombro e Cotovelo, Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil.
  • Silva LAD; Departamento de Cirurgia Ortopédica, Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo) ; 57(4): 590-598, 2022 Aug.
Article em En | MEDLINE | ID: mdl-35966441
Objective The primary aim of the present study is to evaluate the functional results of a modification to the latissimus dorsi (LD) transfer around the shoulder for irreparable posterosuperior rotator cuff tears. The secondary aim is to evaluate variables that might influence the outcomes. Surgical Technique Through a single deltopectoral approach, the LD tendon is detached, reinforced, and elongated with a tendinous allograft, transferred around the humerus, and fixed superolaterally to the greater tuberosity and anteriorly to the subscapularis. Methods Retrospective functional evaluation of 16 cases. The average follow-up was 21 months (12-47). The postoperative results (at last follow-up) were compared with the preoperative ones, as well as to other pre, intra, and postoperative variables. Results All (but one) patients were satisfied. Average University of California, Los Angeles (UCLA) score increased from 11.6 (8-16) to 27.3 (17-30) ( p < 0.001). Improvements of shoulder pain, function, and strength achieved statistical significance ( p < 0.001). Nonetheless, normal strength was never restored. Average active range of motion improved as follows: forward elevation, from 106° (60-140°) to 145° (130-160°) ( p < 0.001); external rotation from 30° (0° to 60°) to 54° (40-70°) ( p < 0.001); and internal rotation from L1 (gluteus to T7) to T10 (T12-T3) ( p < 0.05). No complication has occurred. Preoperative pseudoparesis was reverted in all the six cases in which it was present. None of the variables analyzed influenced the outcomes, including pseudoparesis. Conclusions At early follow-up, this technique is safe and effective at recovering from pseudoparesis and at improving shoulder pain, function, and strength.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Rev Bras Ortop (Sao Paulo) Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Rev Bras Ortop (Sao Paulo) Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha