2015 ISAKOS Biennial Congress ePoster #2432

Arthroscopic Assisted Latissimus Dorsi Tendon Transfer Versus Arthroscopic Repair for the Management of Massive Rotator Cuff Tears

Umile Giuseppe Longo, MD, MSc, PhD, Prof., Rome ITALY
Giacomo Rizzello, Tricase ITALY
Roberto Castricini, MD, Falconara Marittima ITALY
Stefano Petrillo, MD, Rome ITALY
Mattia Loppini, MD, Rome ITALY
Massimo De Benedetto , MD, Ravenna ITALY
Raul Zini, MD, Ravenna ITALY
Nicola Maffulli, MD, PhD, MS, FRCS(Orth), London UNITED KINGDOM
Vincenzo Denaro, MD, PhD, Prof., Rome ITALY

Departement of Orhoaedics and Trauma Sugery, Campus Bio-Medico University of Rome, Rome, Rome, ITALY

FDA Status Not Applicable

Summary: Arthroscopic assisted Latissimus Dorsi tendon transfer versus arthroscopic repair for the management of massive rotator cuff tears

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Abstract:

Background

The management of massive rotator cuff tears (MRCT) represents a challenge. Arthroscopic assisted Latissimus dorsi muscle-tendon transfer (aLDT) and arthroscopic repair (AR) are two valuable options for the treatment of MRCT.

Methods

A total of 58 patients presenting MRCT have been enrolled in the study. 27 patients (16 males and 11 females; mean age 60 years, range 46-67 years) underwent aLDT (group A), while 31 patients (18 males and 13 females; mean age 62 years, range 40-72 years) underwent AR (group B). Outcome measures included the Constant and Murley score, shoulder range of motion in external rotation, and muscle strength in forward elevation. The mean duration of follow-up was 27 months (range 24-36) in group A and 36 months (range 12-48) in group B.
The outcome variables considered (Constant and Murley score, shoulder range of motion in external rotation, and muscle strength in forward elevation) have been compared using a two-tailed Mann-Whitney U test. The significance was set at P< 0.05. The independent variables analyzed were: age; sex; arm dominance. Comparison between the two groups for each independent variable was carried out with a two-tailed Mann-Whitney U test for continuous variables and the x2 test for categorical variables.

Results

There were no differences between the two groups for each independent variable considered (age; sex; arm dominance). The mean Constant Murley score was 74 points (40-84) in group A and 72 points (range 45-90) in group B (P= 0.65). The external rotation averaged 38° (range, 22°-40°) in group A and 35° (15-45°) in group B (P< 0.05). The mean muscle strength in forward elevation was 1.8 Kg (range 0.5-4 Kg) in group A and 4 kg (range 2-7 Kg) in group B (P< 0.05).

Conclusions

No differences in terms of Constant Murley score have been found between the two groups. Patients who underwent aLDT showed a significantly better external rotation. On the other hand, patients who underwent AR showed a significantly better strength in forward elevation.