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Three-dimensional analysis of the shoulder motion in patients with massive irreparable cuff tears after latissimus dorsi tendon transfer (LDT)

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Latissimus dorsi tendon transfer (LDT) is a recent method for surgical treatment of massive, irreparable posterosuperior cuff tears (MIPCT). So far, there are no studies on the quantitative motion analysis of the shoulder and latissimus dorsi (LD) muscle activation after LDT. The changes in shoulder movements after LDT can be objectively assessed by the 3-D motion analysis. These changes may not be due to an increased activity of the LD muscle as external rotator.

Materials and methods

The shoulder kinematics of nine patients with MIPCT were recorded through a 3-D motion analysis system, before LTD (T0), and after 3 (T1) and 6 (T2) months post-LDT. Maximal shoulder flexion–extension, abduction–adduction, and horizontal abduction–adduction, and the internal and external circumduction of the shoulder joint were measured during upright standing posture. Surface EMG activity of the LD muscle was recorded during both internal rotation (IR) and external rotation (ER) tasks in three different postures.

Results

A significant increase of shoulder movements was observed at T2 compared with T0 for almost all motor tasks. A significant effect of LDT was also found on LD-IR/ER ratio in posture 1 at T2 compared with T0 and T1. No significant effects were found for the LD-IR/ER ratio in the other postures.

Conclusions

Our study indicates that LDT is effective in shoulder motion recovery. Such improvement is not associated with a change in function of the LD muscle, which may be induced by a depression of the humeral head into the glenoid cavity instead.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 40100, Latina, Italy

    Giorgio Ippolito, Mariano Serrao, Francesco Napoli, Massimo Miscusi, Francesco Pierelli & Giuseppe Costanzo

  2. Movement Analysis LAB, Rehabilitation Centre Policlinico Italia, Piazza del Campidano 6, 00162, Rome, Italy

    Mariano Serrao

  3. Don Gnocchi Foundation, Milan, Italy

    Carmela Conte

  4. Department of Neurophysiology of Vision and Neurophthalmology, G.B. Bietti Foundation-IRCCS, Via Livenza 3, 00198, Rome, Italy

    Gianluca Coppola

  5. IRCCS Neuromed, Pozzilli, IS, Italy

    Francesco Pierelli

  6. Traumatic Orthopedic Surgical Institute, ICOT, Latina, Italy

    Vincenzo De Cupis

Authors
  1. Giorgio Ippolito
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  2. Mariano Serrao
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  3. Francesco Napoli
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  4. Carmela Conte
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  5. Massimo Miscusi
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  6. Gianluca Coppola
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  7. Francesco Pierelli
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  8. Giuseppe Costanzo
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  9. Vincenzo De Cupis
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Corresponding author

Correspondence to Mariano Serrao.

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Funding

This study was funded by the Sapienza University of Rome.

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The authors declare that they have no conflict of interest.

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Ippolito, G., Serrao, M., Napoli, F. et al. Three-dimensional analysis of the shoulder motion in patients with massive irreparable cuff tears after latissimus dorsi tendon transfer (LDT). Arch Orthop Trauma Surg 136, 1363–1370 (2016). https://doi.org/10.1007/s00402-016-2547-0

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