Document Detail

Modified L'Episcopo tendon transfers for irreparable rotator cuff tears: 5-year follow-up.
MedLine Citation:
PMID:  19685265     Owner:  NLM     Status:  MEDLINE    
Patients with posterosuperior cuff tears lose functional external rotation of the shoulder. Latissimus dorsi and teres major transfer is performed to restore external rotation. Twenty patients with a mean age was 55.8 +/- 6 years underwent this procedure and were examined at averages of 24.7 (n = 17) and 70.6 (n = 13) months. Two patients did not improve presumably because of failure of the transfer. The Constant and Murley score increased from 55.6 to 90.4 after 2 years and to 87.9 after 5 years. The mean active flexion increased from 119.4 degrees to 169.3 degrees and reached 170 degrees after 5 years, and mean external rotation increased from 12 degrees to 35 degrees , finally reaching 23 degrees . The grade of cuff arthritis progressed from initially Grade 1 in 17% and Grade 2 in 28% to Grade 2 in 8%, Grade 3 in 69%, and Grade 4 in 15% at final followup. The acromiohumeral distance increased from 4.5 mm to 6 mm and decreased to 3.8 mm after 5 years. Electromyographic analysis showed activity during isometric internal and external rotation in the transferred muscle in all patients. The L'Episcopo procedure can restore shoulder function, but cuff arthropathy may progress. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Christian Gerhardt; Lars Lehmann; Sven Lichtenberg; Peter Magosch; Peter Habermeyer
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Publication Detail:
Type:  Journal Article     Date:  2009-08-15
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-05-20     Revised Date:  2011-07-28    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1572-7     Citation Subset:  AIM; IM    
Charité Universitätsmedizin Berlin, Centrum für muskuloskeletale Chirurgie, Augustenburger Platz 1, 13353 Berlin, Germany.
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MeSH Terms
Disability Evaluation
Magnetic Resonance Imaging
Middle Aged
Osteoarthritis / etiology
Pain Measurement
Range of Motion, Articular
Recovery of Function
Rotator Cuff / injuries,  physiopathology,  radiography,  surgery*
Shoulder Joint / physiopathology,  radiography,  surgery*
Shoulder Pain / etiology,  prevention & control
Tendon Injuries / diagnosis,  physiopathology,  surgery*
Tendon Transfer / adverse effects,  methods*
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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