Document Detail


Teres minor integrity predicts outcome of latissimus dorsi tendon transfer for irreparable rotator cuff tears.
MedLine Citation:
PMID:  17980629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In patients with irreparable rotator cuff tears, latissimus dorsi tendon transfer (LDTT) can be effective in improving pain and function. However, the results are variable, and the factors that predict good outcomes are poorly understood. The purpose of this study was to investigate whether the integrity of the teres minor musculotendinous unit is predictive of outcome following LDTT. Twenty-two consecutive patients who underwent LDTT for massive, irreparable posterosuperior rotator cuff tears were retrospectively reviewed. Sixteen men and 6 women with a mean age of 58 years (range, 40-68) were analyzed at an average follow-up of 34 months (range, 24-57). Standardized MRI images of all patients were reviewed by 3 independent reviewers. Fatty infiltration of the teres minor was Goutallier stage 0 in 5 patients; stage 1 in 6; stage 2 in 4; stage 3 in 6; and stage 4 in 1. Eleven patients (50%) had partial tears and 2 (9%) had complete tears of the teres minor tendon. Following LDTT, the mean absolute constant score improved from 48 to 62 points (P = .003), age-adjusted constant score improved from 56% to 72% (P = .002), and the subjective shoulder value improved from 24% to 68% (P < .001). Fatty infiltration of the teres minor less than or equal to stage 2 was associated with a better postoperative constant score (67 vs 53, P = .015); age-adjusted constant score (78% vs 59%, P = .012); active external rotation (36 degrees vs 16 degrees , P = .016); and active elevation (143 degrees vs 115 degrees , P = .012) relative to patients with fatty infiltration greater than stage 2. The presence or absence of a tear of the tendon had no significant effect on outcome. In conclusion, when performing LDTT for massive irreparable posterosuperior rotator cuff tears, fatty infiltration of the teres minor should be considered prior to surgery, as it is predictive of outcome.
Authors:
John G Costouros; Norman Espinosa; Marius R Schmid; Christian Gerber
Related Documents :
19945819 - Replacement of the proximal humerus with mutars tumor endoprostheses.
11400899 - Treatment of calcifying tendinitis of the shoulder with shock wave therapy.
16831649 - Long-term results of scapulothoracic arthrodesis of facioscapulohumeral muscular dystro...
19481959 - Reverse total shoulder arthroplasty after failed rotator cuff surgery.
20553609 - Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous b...
19409309 - The effect of forced-air warming during arthroscopic shoulder surgery with general anes...
18322739 - Minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prosp...
15964709 - Cognitive function after radiotherapy for supratentorial low-grade glioma: a north cent...
8817019 - Mechanical versus co2 laser occlusion of the posterior semicircular canal in humans.
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2007-11-05
Journal Detail:
Title:  Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]     Volume:  16     ISSN:  1532-6500     ISO Abbreviation:  J Shoulder Elbow Surg     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-01-29     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  9206499     Medline TA:  J Shoulder Elbow Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  727-34     Citation Subset:  IM    
Affiliation:
University of Zurich, Balgrist University Hospital, Zurich, Switzerland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adipose Tissue
Adult
Aged
Arthroscopy*
Female
Humans
Magnetic Resonance Imaging*
Male
Middle Aged
Muscular Atrophy
Predictive Value of Tests
Rotator Cuff / injuries*,  pathology,  surgery*
Shoulder Joint / pathology*
Tendon Transfer / methods*
Treatment Outcome

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


Previous Document:  Optimized analysis of the forced swim test using an automated experimental system: detailed time cou...
Next Document:  Nitric oxide induced oxidative changes in erythrocyte membrane components.