title: Three-dimensional analysis of the shoulder motion in patients with massive irreparable cuff tears after latissimus dorsi tendon transfer (LDT).
abstract: BACKGROUND
  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.
  
  
  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.
authors: Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 40100, Latina, Italy.
authors: Giorgio
authors: G
authors: Ippolito
authors: Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 40100, Latina, Italy. mariano.serrao@uniroma1.it.|Movement Analysis LAB, Rehabilitation Centre Policlinico Italia, Piazza del Campidano 6, 00162, Rome, Italy. mariano.serrao@uniroma1.it.
authors: Mariano
authors: M
authors: Serrao
authors: Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 40100, Latina, Italy.
authors: Francesco
authors: F
authors: Napoli
authors: Don Gnocchi Foundation, Milan, Italy.
authors: Carmela
authors: C
authors: Conte
authors: Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 40100, Latina, Italy.
authors: Massimo
authors: M
authors: Miscusi
authors: Department of Neurophysiology of Vision and Neurophthalmology, G.B. Bietti Foundation-IRCCS, Via Livenza 3, 00198, Rome, Italy.
authors: Gianluca
authors: G
authors: Coppola
authors: Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 40100, Latina, Italy.|IRCCS Neuromed, Pozzilli, IS, Italy.
authors: Francesco
authors: F
authors: Pierelli
authors: Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 40100, Latina, Italy.
authors: Giuseppe
authors: G
authors: Costanzo
authors: Traumatic Orthopedic Surgical Institute, ICOT, Latina, Italy.
authors: Vincenzo
authors: V
authors: De Cupis
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009068:Movement; D012399:Rotation; D000070636:Rotator Cuff Injuries / Q000503:physiopathology / Q000601:surgery*; D012782:Shoulder / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D064171:Superficial Back Muscles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013709:Tendon Transfer; D013996:Time and Motion Studies; D016896:Treatment Outcome
keywords: 3-D motion analysis; Latissimus dorsi tendon transfer; Massive irreparable posterosuperior cuff tears; Shoulder kinematics