Abstract：
Latissimus dorsi transfer is a surgical procedure that can be used for treating posterosuperior rotator cuff tears. The procedure leads to improved shoulder function via alterations in the force vector couple around the shoulder. However, there is still no consensus on the biomechanical changes resulting from latissimus dorsi transfer.
We performed a systematic review of the literature on 3D motion analysis studies evaluating the effects of latissimus dorsi transfer on shoulder kinematics. The available data on segment and joint range of motion was extracted and subject to meta-analysis when consistent across the studies.
Our meta-analysis of pre- and post-operative studies revealed a significant improvement in forward flexion and abduction following latissimus dorsi transfer. When comparing the latissimus transferred shoulder with an uninjured contralateral side the meta-analysis found no significant difference in flexion range of motion, while abduction and external rotation was significantly higher in the uninjured shoulders. The overall risk of bias was moderate to high. High heterogeneity was found in the reporting of data, which limited our ability to perform a meta-analysis across the studies for all interest outcomes.
Our findings suggest that latissimus dorsi transfer for posterosuperior rotator cuff tears effectively improves shoulder flexion and abduction. External rotation is also expected to improve but at inferior levels as compared to the unaffected side. However, the heterogeneity of the reported data on 3D motion analysis studies highlights the need for better standardization in research and reporting as to conclude the impact of different joints.
We performed a systematic review of the literature on 3D motion analysis studies evaluating the effects of latissimus dorsi transfer on shoulder kinematics. The available data on segment and joint range of motion was extracted and subject to meta-analysis when consistent across the studies.
Our meta-analysis of pre- and post-operative studies revealed a significant improvement in forward flexion and abduction following latissimus dorsi transfer. When comparing the latissimus transferred shoulder with an uninjured contralateral side the meta-analysis found no significant difference in flexion range of motion, while abduction and external rotation was significantly higher in the uninjured shoulders. The overall risk of bias was moderate to high. High heterogeneity was found in the reporting of data, which limited our ability to perform a meta-analysis across the studies for all interest outcomes.
Our findings suggest that latissimus dorsi transfer for posterosuperior rotator cuff tears effectively improves shoulder flexion and abduction. External rotation is also expected to improve but at inferior levels as compared to the unaffected side. However, the heterogeneity of the reported data on 3D motion analysis studies highlights the need for better standardization in research and reporting as to conclude the impact of different joints.
摘要：
背景：背阔肌转移是一种可用于治疗后上肩袖撕裂的外科手术。该程序通过改变肩部周围的力矢量耦合来改善肩部功能。然而,关于背阔肌转移引起的生物力学变化仍未达成共识。
方法：我们对评估背阔肌转移对肩运动学影响的3D运动分析研究的文献进行了系统回顾。提取有关节段和关节运动范围的可用数据，并在所有研究一致时进行荟萃分析。
结果：我们对术前和术后研究的荟萃分析显示，背阔肌转移后前屈和外展有显著改善。当比较背阔肌转移的肩关节与未受伤的对侧时，荟萃分析发现屈曲活动范围没有显着差异。而外展和外旋在未受伤的肩膀上明显更高。总体偏倚风险为中等至高。在数据报告中发现高度异质性，这限制了我们对所有兴趣结局的研究进行荟萃分析的能力。
结论：我们的研究结果表明，背阔肌移位治疗后上肩袖撕裂可有效改善肩关节屈曲和外展。与未受影响的一侧相比，外部旋转也有望改善，但水平较差。然而,关于3D运动分析研究的报告数据的异质性突出表明,需要在研究和报告中更好地标准化,以得出不同关节的影响.
方法：我们对评估背阔肌转移对肩运动学影响的3D运动分析研究的文献进行了系统回顾。提取有关节段和关节运动范围的可用数据，并在所有研究一致时进行荟萃分析。
结果：我们对术前和术后研究的荟萃分析显示，背阔肌转移后前屈和外展有显著改善。当比较背阔肌转移的肩关节与未受伤的对侧时，荟萃分析发现屈曲活动范围没有显着差异。而外展和外旋在未受伤的肩膀上明显更高。总体偏倚风险为中等至高。在数据报告中发现高度异质性，这限制了我们对所有兴趣结局的研究进行荟萃分析的能力。
结论：我们的研究结果表明，背阔肌移位治疗后上肩袖撕裂可有效改善肩关节屈曲和外展。与未受影响的一侧相比，外部旋转也有望改善，但水平较差。然而,关于3D运动分析研究的报告数据的异质性突出表明,需要在研究和报告中更好地标准化,以得出不同关节的影响.
