Traumatology and Orthopedics of RussiaTraumatology and Orthopedics of RussiaТравматология и ортопедия России2311-29052542-0933Vreden National Medical Research Center of Traumatology and Orthopedics201710.17816/2311-2905-2017ReviewsОбзорыReviewsReview ArticleOptions in Tendon Transfers for Anterior-Superior Rotator Cuff Tears: ReviewВарианты сухожильных трансферов при передневерхних разрывах вращательной манжеты плечевого сустава: обзор зарубежной литературыhttps://orcid.org/0000-0001-6623-2144ShershnevAndrei M.ШершневАндрей Максимович
Russian Federation
andreyshersh@gmail.comhttps://orcid.org/0000-0003-1890-4342DokolinSergei Yu.ДоколинСергей Юрьевич
Russian Federation

Dr. Sci. (Med.)

д-р мед. наук

sdokolin@gmail.comhttps://orcid.org/0000-0001-7866-5545KuzminaVladislava I.КузьминаВладислава Игоревна
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук

tasha_777@bk.ruhttps://orcid.org/0000-0001-8746-5414KutuzovMatvei O.КутузовМатвей Олегович
Russian Federation
kutuzovsky1995@gmail.comhttps://orcid.org/0000-0002-3000-2344YaretsElizaveta V.ЯрецЕлизавета Валерьевна
Russian Federation
yaretcliza@mail.ruVreden National Medical Research Center of Traumatology and OrthopedicsФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Р.Р. Вредена» Минздрава России02022023110420232911351422810202230112022Copyright ©; 2023, Eco-VectorCopyright ©; 2023, Эко-ВекторCopyright ©; 2023,2023Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://journal.rniito.org/jour/article/view/2017

Background. Irreparable anterior-superior rotator cuff tears can cause significant shoulder dysfunction due to the failure of normal biomechanics of the joint, because of the loss of compressive effect of the rotator cuff on the humeral head. Muscle-tendon transfers are an alternative to standard surgical treatment options: debridement of injured tendons, arthroscopic anchor suture, and reverse shoulder arthroplasty. Currently, several options of muscle-tendon transfers are described in the foreign literature, and there is an active discussion over the results of the already proposed techniques, and their improvements, while these techniques are practically not covered in the domestic literature.

The aim — to describe modern surgical technique options of the muscle-tendon transfers for the treatment of patients with anterior-superior rotator cuff tears based on a review of foreign literature sources.

Methods. The search for publications from 1988 to 2022 was carried out in the PubMed/MEDLINE and Google Scholar databases.

Results. Nowadays, the most common muscle-tendon transfers options for patients with anterior-superior rotator cuff tears are the sternocostal portion of the of pectoralis major tendon transfer and the latissimus dorsi tendon transfer. A review of foreign literature showed that muscle-tendon transfers are a well-described alternative to standard methods of treating profile patients with a predictable result.

Conclusion. Currently, there is no consensus on clear indications for certain types of muscle-tendon transfers in case of anterior-superior rotator cuff tears, there is a lack of data on long-term results. This determines the need of study of the long-term clinical results of use of these methods and develop an algorithm for choosing the tactics of surgical treatment of relevant patients.

Актуальность. Невосстановимые передневерхние разрывы вращательной манжеты могут значительно ухудшить функцию плечевого сустава из-за нарушения нормальной биомеханики сустава в связи с утратой компрессирующего действия вращательной манжеты на головку плечевой кости. Мышечно-сухожильные трансферы являются альтернативой стандартным вариантам хирургического лечения: дебридменту поврежденных сухожилий, артроскопическому якорному шву и реверсивному эндопротезированию плечевого сустава. В зарубежной литературе описано несколько вариантов мышечно-сухожильных трансферов для лечения этой патологии и ведется активное обсуждение результатов уже предложенных техник, а также их усовершенствование, в то время как в отечественной литературе данные методики практически не освещены.

Цель обзора — на основе анализа публикаций оценить современные хирургические техники мышечно-сухожильных трансферов при лечении пациентов с передневерхними разрывами вращательной манжеты плечевого сустава.

Материал и методы. Поиск публикаций осуществлялся в базах данных PubMed/MEDLINE и Google Scholar с 1988 по 2022 г.

Результаты. В настоящее время наибольшее распространение получили мышечно-сухожильные трансферы грудинно-реберной порции сухожилия большой грудной мышцы и сухожилия широчайшей мышцы спины, которые являются альтернативой стандартным методам лечения с предсказуемым результатом.

Заключение. В настоящее время нет единого мнения о четких показаниях к тем или иным вариантам мышечно-сухожильных трансферов при передневерхних разрывах вращательной манжеты плечевого сустава, недостаточно данных об отдаленных результатах. Это определяет необходимость изучения отдаленных клинических результатов применения данных методов и разработки алгоритма выбора тактики хирургического лечения профильных пациентов.

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