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Teres major tendon transfer in the treatment of irreparable posterosuperior rotator cuff tears.

Abstract Aims Since long-term outcome of teres major tendon transfer surgery for irreparable posterosuperior rotator cuff (RC) tears is largely unknown, the primary aim of this study was to evaluate the long-term outcome of the teres major transfer. We also aimed to report on the results of a cohort of patients with a similar indication for surgery that underwent a latissimus dorsi tendon transfer. Patients and Methods In this prospective cohort study, we reported on the long-term results of 20 consecutive patients with a teres major tendon transfer for irreparable massive posterosuperior RC tears. Additionally, we reported on the results of the latissimus dorsi tendon transfer (n = 19). The mean age was 60 years (47 to 77). Outcomes included the Constant score (CS), and pain at rest and during movement using the Visual Analogue Scale (VAS). Results At a mean of ten years (8 to 12) following teres major transfer, the CS was still 23 points (95% confidence interval (CI) 14.6 to 30.9, p < 0.001) higher than preoperatively. VAS for pain at rest (21 mm, 95% CI 4.0 to 38.9, p = 0.016) and movement (31 mm, 95% CI 16.0 to 45.1, p < 0.001) were lower than preoperatively. We also found an increase in CS (32 points, 95% CI 23.4 to 40.2, p < 0.001) and reduction of pain (26 mm, 95% CI 9.9 to 41.8, p = 0.001) six years after latissimus dorsi transfer. Conclusion Teres major tendon transfer is a treatment option to gain shoulder function and reduce pain in patients with an irreparable posterosuperior RC tear at a mean follow-up of ten years. The teres major tendon might be a valuable alternative to the commonly performed latissimus dorsi tendon transfer in the treatment of irreparable posterosuperior RC tears. Cite this article: Bone Joint J 2018;100-B:309-17.
PMID
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Authors

Mayor MeshTerms
Keywords

Massive rotator cuff tear

Pain

Quality of life

Shoulder

Surgery

Tendon transfer

Journal Title the bone & joint journal
Publication Year Start




PMID- 29589499
OWN - NLM
STAT- MEDLINE
DCOM- 20180402
LR  - 20180402
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 3
DP  - 2018 Mar 1
TI  - Teres major tendon transfer in the treatment of irreparable posterosuperior
      rotator cuff tears.
PG  - 309-317
LID - 10.1302/0301-620X.100B3.BJJ-2017-0920.R1 [doi]
AB  - Aims Since long-term outcome of teres major tendon transfer surgery for
      irreparable posterosuperior rotator cuff (RC) tears is largely unknown, the
      primary aim of this study was to evaluate the long-term outcome of the teres
      major transfer. We also aimed to report on the results of a cohort of patients
      with a similar indication for surgery that underwent a latissimus dorsi tendon
      transfer. Patients and Methods In this prospective cohort study, we reported on
      the long-term results of 20 consecutive patients with a teres major tendon
      transfer for irreparable massive posterosuperior RC tears. Additionally, we
      reported on the results of the latissimus dorsi tendon transfer (n = 19). The
      mean age was 60 years (47 to 77). Outcomes included the Constant score (CS), and 
      pain at rest and during movement using the Visual Analogue Scale (VAS). Results
      At a mean of ten years (8 to 12) following teres major transfer, the CS was still
      23 points (95% confidence interval (CI) 14.6 to 30.9, p &lt; 0.001) higher than
      preoperatively. VAS for pain at rest (21 mm, 95% CI 4.0 to 38.9, p = 0.016) and
      movement (31 mm, 95% CI 16.0 to 45.1, p &lt; 0.001) were lower than preoperatively. 
      We also found an increase in CS (32 points, 95% CI 23.4 to 40.2, p &lt; 0.001) and
      reduction of pain (26 mm, 95% CI 9.9 to 41.8, p = 0.001) six years after
      latissimus dorsi transfer. Conclusion Teres major tendon transfer is a treatment 
      option to gain shoulder function and reduce pain in patients with an irreparable 
      posterosuperior RC tear at a mean follow-up of ten years. The teres major tendon 
      might be a valuable alternative to the commonly performed latissimus dorsi tendon
      transfer in the treatment of irreparable posterosuperior RC tears. Cite this
      article: Bone Joint J 2018;100-B:309-17.
FAU - Kolk, A
AU  - Kolk A
AD  - Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO
      box 9600, 2300 RC Leiden, The Netherlands.
FAU - Henseler, J F
AU  - Henseler JF
AD  - Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO
      box 9600, 2300 RC Leiden, The Netherlands.
FAU - Overes, F J
AU  - Overes FJ
AD  - Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO
      box 9600, 2300 RC Leiden, The Netherlands.
FAU - Nagels, J
AU  - Nagels J
AD  - Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO
      box 9600, 2300 RC Leiden, The Netherlands.
FAU - Nelissen, R G H H
AU  - Nelissen RGHH
AD  - Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO
      box 9600, 2300 RC Leiden, The Netherlands.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone &amp; joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Prospective Studies
MH  - Rotator Cuff Injuries/*surgery
MH  - Superficial Back Muscles/*transplantation
MH  - Tendon Transfer/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Massive rotator cuff tear
OT  - Pain
OT  - Quality of life
OT  - Shoulder
OT  - Surgery
OT  - Tendon transfer
EDAT- 2018/03/29 06:00
MHDA- 2018/04/03 06:00
CRDT- 2018/03/29 06:00
PHST- 2018/03/29 06:00 [entrez]
PHST- 2018/03/29 06:00 [pubmed]
PHST- 2018/04/03 06:00 [medline]
AID - 10.1302/0301-620X.100B3.BJJ-2017-0920.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Mar 1;100-B(3):309-317. doi:
      10.1302/0301-620X.100B3.BJJ-2017-0920.R1.