Arthroscopic-assisted latissimus dorsi transfer for subscapularis deficiency
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Few salvage procedures have been described in case of irreparable subscapularis tear and with variable outcomes. Latissimus dorsi transfer has been widely proposed as a transfer for irreparable posterio-superior rotator cuff tear with good outcomes. The anatomic feasibility of the latissimus dorsi to reconstruct the antero-superior irreparable rotator cuff tear has been suggested, but no clinical study has ever been published. We hypothesized that it was possible to use an arthroscopic-assisted latissimus dorsi transfer to reconstruct the subscapularis function. Five patients were enrolled. A 5–7-cm axillary incision was performed to release the latissimus dorsi tendon from its humeral insertion, the teres major muscle and the apex of the scapula. Afterwards, under arthroscopic control, a 7-mm-diameter tunnel was drilled at the anterior and superior part of the humeral head with an oblique inferior and posterior direction. The tubularized latissimus dorsi tendon was introduced into the tunnel and fixed with a ZipLoop on the posterior humeral cortex. The authors show overall good experience with this technique.
Level of evidence
Level IV-a, case series.
KeywordsLatissimus Transfer Arthroscopy Irreparable Subscapularis Transfer
We acknowledge the effort of Philippe Perroud for the sketches.
Compliance with ethical standards
Conflict of interest
Author Jean Kany has received research grants from Company FH, has received a speaker honorarium from Company FH, Mitek and Tornier. Author Philippe Valenti has received research grants from Company FH, has received a speaker honorarium from Company FH and Biomet. Author Jean Grimberg has received research grants from Company Smith Nephew. Author Pierre Croutzet declares that he has no conflict of interest. Author Jean David Werthel declares that he has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Supplementary material 1 (MOV 397762 kb)
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