Background: Massive irreparable posterosuperior rotator cuff tears may result in the loss of external rotation. Most of the patients with posterosuperior rotator cuff tears suffer from a restriction in their daily life actions. Latissimus dorsi tendon transfer (LDTT) is a method to restore abduction and external rotation in these patients. However, the behavior of the LD after the transfer is not clear yet. Few studies have analyzed the activity of the LD after transfer. The goal of this study was to examine the function of the LD postoperatively in follow-up examinations during activities of daily life (ADLs) and during different movements evaluated by measuring the range of motion (ROM). Methods: We examined 12 patients 4.3 years (1–9 years) after LDTT, using simultaneous 3D motion analysis and surface Electromyography (sEMG) of 12 muscle parts; the opposite, nonaffected side was assessed as a control. The measurement protocol included two standardized movements (exorotation with an adducted arm and exorotation with 90° abduction) as well as two ADLs (combing hair and perineal care). Results: An average of 4.3 years (1–9 years) after LDTT, 9 of the 12 subjects showed EMG activity in the transferred LD during glenohumeral external rotation. During the endorotation phase, either little activity was registered or only the pectoralis major was active. During the ADLs, 6 out of 12 subjects showed EMG activity in the transferred LD while “combing hair”, whereas all subjects showed EMG activity during perineal care. Conclusion: The LD showed partial activity in its new role as an exorotator, but no clear difference was observed between some of the movements as well as in comparison with the healthy shoulder. Further studies will need to be conducted to better differentiate voluntary contractions and co-contractions as well as tension and extension in the muscle.

The purpose of this study was to evaluate the clinical, functional, and radiographic outcomes in patients who underwent two-stage cementless arthrodesis following multiple revision surgeries for periprosthetic joint infection, after a mean follow-up of 57.0 months (range, two to 208). From 2002 to 2012, 31 patients underwent a two-stage revision for periprosthetic joint infection using an intramedullary modular arthrodesis system. The follow-up evaluation included clinical and functional data, as assessed using the Oxford Knee Score. Furthermore, a gait analysis using three-dimensional motion analysis was performed for five patients. There were 29 patients available for clinical and radiographic follow-up. The mean bone defect was 3.9 centimeters. There was one reoperation for postoperative hematoma with preservation of the arthrodesis. There were six reinfections after arthrodesis. In three of these cases, preservation of the arthrodesis system was possible after repeated revision surgeries. In two cases, the recurrent infection was treated with another two-stage revision and rearthrodesis. In one case, the arthrodesis system was removed, and a spacer was implanted. The Kaplan-Meier survival rate was 87.2% (95% confidence interval, 65.3 to 95.7) at 17.3 years for revision for any reason. The risk of reinfection was 19% following two-stage arthrodesis. The limb salvage rate was 100%. Periprosthetic joint infection can be successfully treated with arthrodesis using a modular intramedullary arthrodesis system without bone-to-bone fusion. Although the risk of reinfection following two-stage revision is 19%, this treatment approach may provide patients with improved quality of life by relieving pain and restoring joint stability.