Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears

Abstract

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Massive rotator cuff tears: pathomechanics, current treatment options, and clinical outcomes

“…15 Results were similar to those of previous studies. Less strength in forward elevation and lower Constant scores were observed for revision surgeries relative to primary surgeries.…”

“…121 Clinical outcomes Studies regarding the clinical outcomes of latissimus dorsi tendon transfers are summarized in Supplementary Table III. 3,15,20,23,26,29,41,[43][44][45]61,62,75,89,92,98,116,121,122 A systematic review conducted by Namdari et al analyzed 10 studies between 1992 and 2010 to determine the expected outcomes, predictive factors for success, and complications of latissimus dorsi transfers. 94 Frequency-weighted mean follow-up was 45.5 months.…”

Management of complications after rotator cuff surgery

“…However, poor results are often seen in patients with subscapularis insufficiency and teres minor fatty infiltration [110,111]. Arthroscopic assisted latissimus transfer has also been reported with comparable short-term results to formal open transfer [114]. The main benefit of the procedure is avoiding the detachment of the deltoid from the acromion and potential postoperative deltoid complications that have been associated with trans-deltoid approaches to the shoulder.…”

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“…• Eliminating postero-advanced cuff induces a decrease of shoulder second-generating ability in flexion, abduction, and external rotation, [18,35,37] an growth of inner rotation and latero-advanced excursion of humeral head, and a decrease in gleno-humeral contact vicinity. [38] • In finite detail model studies, moving the LD tendon to the supraspinatus insertion is much less favorable to repair biomechanical situations of the everyday shoulder than moving the LD tendon to the infraspinatus insertion.…”

“…[14] Although only a handful of studies have evaluated outcomes of arthroscopic LDTT, findings of these studies are more than satisfying especially in terms of absence of occurrence of glenohumeral arthritis and absence of diminution of subacromial space. [18,19] Eventually this leads to upwards drifting of head of humerus and finally cuff arthropathy ensues. [1] External rotation of shoulder is hampered in PSCTs when teres major is damaged, hence transfer of teres major tendon is occasionally done with LDTT in such cases.…”