Browsing by Author "Morrey, Mark E."

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    Lower Trapezius Transfer Improves Clinical Outcomes With a Rate of Complications and Reoperations Comparable to Other Surgical Alternatives in Patients with Functionally Irreparable Rotator Cuff Tears: A Systematic Review
    (2023) Marinis Acle, Rodrigo Ignacio de; Marigi, Erick; Atwan, Yousif; Velásquez García, Ausberto; Morrey, Mark E.; Sánchez Sotelo, Joaquin
    Purpose To analyze the clinical outcomes of lower trapezius transfer (LTT) for patients with functionally irreparable rotator cuff tears (FIRCT) and summarize the available literature regarding complications and reoperations. Methods After registration in the International prospective register of systematic reviews(PROSPERO [CRD42022359277]), a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Inclusion criteria were English, full-length, peer-reviewed publications with a level of evidence IV or higher reporting on clinical outcomes of LTT for FIRCT. Ovid MEDLINE(R), Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus via Elsevier databases were searched. Clinical data, complications and revisions were systematically recorded. Results Seven studies with 159 patients were identified. The mean age range was 52 – 63 years, 70.4% of the patients included were male, and the mean follow-up time ranged between 14 and 47 months. At final follow-up, LTT lead to improvements in range of motion (ROM), with reported forward elevation (FE) and external rotation (ER) mean gains of 10º – 66º and 11º – 63º, respectively. ER lag was present preoperatively in 78 patients and was reversed after LTT in all shoulders. Patient reported outcomes were improved at final follow-up, including the American Shoulder and Elbow Society score, Shoulder Subjective Value and Visual Analogue Scale. The overall complication rate was 17.6% and the most reported complication was posterior harvest site seroma/hematoma (6.3%). The most common reoperation was conversion to reverse shoulder arthroplasty (5%) with an overall reoperation rate of 7.5%. Conslusions Lower trapezius transfer improves clinical outcomes in patients with irreparable rotator cuff tears with a rate of complications and reoperations comparable to other surgical alternatives in this group of patients. Increases in FF and ER are to be expected, as well as a reversal of ER lag sign when preoperatively present. Level of Evidence Level IV, a systematic review of Level III-IV studies.
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    Mid- to long-term outcomes of latissimus dorsi tendon transfer for massive irreparable posterosuperior rotator cuff tears: a systematic review and meta-analysis
    (2023) Velásquez García, Ausberto; Nieboer, Micah J.; Marinis Acle, Rodrigo Ignacio de; Morrey, Mark E.; Valenti, Philippe; Sánchez-Sotelo, Joaquín
    Background: This study aims to analyze the mid- to long-term results of the latissimus dorsi tendon for the treatment of massive posterosuperior irreparable rotator cuff tears as reported in high-quality publications and to determine its efficacy and safety.Methods: A systematic review was performed according to the PRISMA guidelines. PubMed, Scopus, and EMBASE databases were searched until December 2022 to identify studies with a minimum 4-year follow-up. Clinical and radiographic outcomes, complications, and revision surgery data were collected. The publications included were analyzed quantitatively using the DerSimonian Laird random-effects model to estimate the change in outcomes from the preoperative to the postoperative condition. The proportion of complications and revisions were pooled using the Freeman-Tukey double arcsine transformation.Results: Of the 618 publications identified through database search, 11 articles were considered eligible. A total of 421 patients (432 shoulders) were included in this analysis. Their mean age was 59.5 ± 4 years. Of these, 277 patients had mid-term follow-up (4 to 9 years), and 144 had long-term follow-up (more than 9 years). Postoperative improvements were considered significant for the following outcome parameters: Constant-Murley Score (0-100 scale), with a mean difference (MD) = 28 points (95% CI 21, 36; I2= 89%; P<.001); visual analog scale, with a standardized MD = 2.5 (95%CI 1.7, 3.3; P<.001; I2= 89%; P<.001); forward flexion, with a MD = 43° (95% CI 21°, 65°; I2=95% P<.001); abduction, with a MD = 38° (95% CI 20°, 56°; I2=85%; P < .01), and external rotation, with a MD = 8° (95% CI 1°, 16°; I2=87%; P= .005). The overall reported mean complication rate was 13% (95% CI 9%, 19%; I2=0%), while the reported mean revision rate was 6% (95% CI: 3%, 9%; I2=0%).Conclusions: Our pooled estimated results seem to indicate that latissimus dorsi tendon transfer significantly improves patient-reported outcomes, pain relief, range of motion, and strength, with modest rates of complications and revision surgery at mid- to long-term follow-up. In well-selected patients, latissimus dorsi tendon transfer may provide favorable outcomes for irreparable posterosuperior cuff tears.
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    Reverse Shoulder Arthroplasty Megaprosthesis for Surgical Management of Severe Proximal Humeral Bone Loss
    (2024) Labrum, IV, Joseph T.; De Marinis Acle Rodrigo Ignacio; Atwan, Yousif; Marigi, Erick M.; Houdek, Matthew T.; Barlow, Jonathon D.; Morrey, Mark E.; Sanchez-Sotelo, Joaquin; Sperling, John W.