Journal of shoulder and elbow surgery · 2026
Management of massive rotator cuff tears involving irreparable subscapularis tear by arthroscopically assisted latissimus dorsi transfer: clinical results.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Moussa Mohamad K, Khaled Issam, Nassar Ahmad, Murillo-Nieto Carlos, Maria Suarez-Jimenez Luis José, Valenti Philippe
Аннотация
BACKGROUND: This study aims to evaluate the outcomes of arthroscopically assisted latissimus dorsi (LD) transfer for massive rotator cuff tears involving irreparable subscapularis tendon tears.
METHODS: This case series study was conducted at a specialized Shoulder Unit in Paris from June 2014 to January 2023 to evaluate outcomes of LD transfer for irreparable subscapularis tendon tears. The primary outcome was the Constant score; secondary outcomes included visual analog scale, subjective shoulder value, and satisfaction levels. A subgroup analysis was performed to compare postoperative outcomes between patients with reparable versus irreparable supraspinatus tendons. Additionally, all complications were recorded.
RESULTS: Twenty-one patients, predominantly male (90.5%) with a mean age of 58.6 years (SD 8.2), were included. Most had the right shoulder affected (85.7%), with a mean follow-up of 15.3 months (SD 11.9). The mean Constant score significantly increased from 37.4 ± 9.7 preoperatively to 70.5 ± 11 postoperatively (gain of 31.5 ± 20, P < .001). The mean visual analog scale score decreased from 4.4 ± 1.9 to 1.5 ± 1.5 (reduction of -2.7 ± 2.6, P < .001). The mean subjective shoulder value improved from 49.5 ± 14.3 to 76 ± 11.4 (gain of 25.2 ± 25, P < .001). Satisfaction levels were high, with 16 patients very satisfied, 4 satisfied, and 1 disappointed. Subgroup analysis showed a trend toward better outcomes in the reparable supraspinatus group, although these differences were not statistically significant. Three complications (14.3%) occurred: one surgical failure requiring revision to reverse shoulder arthroplasty, one persistent painful shoulder without functional improvement, and one infection that was resolved with treatment. The Gerber test remained positive in 9 patients (42.9%), and the belly press test remained positive in 3 patients (14.3%).
CONCLUSION: LD transfer for irreparable subscapularis tendon tears leads to significant improvements in shoulder function, pain reduction, and patient satisfaction. While it offers a viable option, residual subscapularis insufficiency persists in a subset of patients.
METHODS: This case series study was conducted at a specialized Shoulder Unit in Paris from June 2014 to January 2023 to evaluate outcomes of LD transfer for irreparable subscapularis tendon tears. The primary outcome was the Constant score; secondary outcomes included visual analog scale, subjective shoulder value, and satisfaction levels. A subgroup analysis was performed to compare postoperative outcomes between patients with reparable versus irreparable supraspinatus tendons. Additionally, all complications were recorded.
RESULTS: Twenty-one patients, predominantly male (90.5%) with a mean age of 58.6 years (SD 8.2), were included. Most had the right shoulder affected (85.7%), with a mean follow-up of 15.3 months (SD 11.9). The mean Constant score significantly increased from 37.4 ± 9.7 preoperatively to 70.5 ± 11 postoperatively (gain of 31.5 ± 20, P < .001). The mean visual analog scale score decreased from 4.4 ± 1.9 to 1.5 ± 1.5 (reduction of -2.7 ± 2.6, P < .001). The mean subjective shoulder value improved from 49.5 ± 14.3 to 76 ± 11.4 (gain of 25.2 ± 25, P < .001). Satisfaction levels were high, with 16 patients very satisfied, 4 satisfied, and 1 disappointed. Subgroup analysis showed a trend toward better outcomes in the reparable supraspinatus group, although these differences were not statistically significant. Three complications (14.3%) occurred: one surgical failure requiring revision to reverse shoulder arthroplasty, one persistent painful shoulder without functional improvement, and one infection that was resolved with treatment. The Gerber test remained positive in 9 patients (42.9%), and the belly press test remained positive in 3 patients (14.3%).
CONCLUSION: LD transfer for irreparable subscapularis tendon tears leads to significant improvements in shoulder function, pain reduction, and patient satisfaction. While it offers a viable option, residual subscapularis insufficiency persists in a subset of patients.