Comparison of arthroscopically assisted transfer of the latissimus dorsi with or without partial cuff repair for irreparable postero-superior rotator cuff tear
To evaluate the effect of an additional partial repair in combination with an arthroscopically assisted transfer of the latissimus dorsi (LDT) in massive postero-superior irreparable cuff tear.
Materials and methods
Thirty-one patients (mean age 59.2 years) scheduled for arthroscopically assisted LDT either isolated or in combination with a partial cuff repair for a massive posterior-superior cuff tear were prospectively included between January 2011 and December 2013 at our institution. Seventeen had an isolated transfer (Group A) and 14 had a transfer combined with a partial cuff repair (Group B). Outcome measures included visual analogue scale (VAS), range of motion, strength, constant score, and subjective shoulder value (SSV). Potential predictive factors were analyzed.
At the last follow-up (mean 22 months), patients in Group B had a significantly higher constant score (64 ± 8 versus 58 ± 4 in Group A), range of motion (33 ± 5 versus 29 ± 5 points in Group A), and strength at 90° of abduction (2.5 kg ± 1 in Group B versus 1.9 kg ± 0.9 in Group A). No significant differences were found between both groups regarding pain scores, SSV, and active external rotation. Thirty-seven variables were analyzed and the only factor which was found to be predictive of a bad result was a preoperative SSV < 40 pts. (RR 0.5).
Arthroscopically assisted LDT gives better results when combined with a partial repair of the cuff than when it is performed isolated in the treatment of massive irreparable postero-superior rotator cuff tear.
Level of evidence: Treatment study, Level II
KeywordsLatissimus dorsi Tendon transfer Massive irreparable cuff tear Partial repair Rotator cuff Arthroscopy Postero-superior cuff tear
Compliance with ethical standards
Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
Conflict of interest
Philippe Valenti and Jean-David Werthel receive royalties for shoulder prosthesis design from FH Orthopedics. The other authors, their immediate families, and any research foundations with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.
Informed consent was obtained from all individual participants included in the study.
- 5.Gerber C, Rahm SA, Catanzaro S, Farshad M, Moor BK (2013) Latissimus dorsi tendon transfer for treatment of irreparable posterosuperior rotator cuff tears: long-term results at a minimum follow-up of ten years. J Bone Joint Surg Am 95(21):1920–1926. https://doi.org/10.2106/JBJS.M.00122 CrossRefPubMedGoogle Scholar
- 7.Deranlot J, Herisson O, Nourissat G, Zbili D, Werthel JD, Vigan M, Bruchou F (2017) Arthroscopic subacromial spacer implantation in patients with massive irreparable rotator cuff tears: clinical and radiographic results of 39 retrospectives cases. Arthroscopy. https://doi.org/10.1016/j.arthro.2017.03.029
- 9.Gerber C, Vinh TS, Hertel R, Hess CW (1988) Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff. A preliminary report. Clin Orthop Relat Res 232:51–61Google Scholar
- 12.Goldstein Y, Grimberg J, Valenti P, Chechik O, Drexler M, Kany J (2013) Arthroscopic fixation with a minimally invasive axillary approach for latissimus dorsi transfer using an endobutton in massive and irreparable postero-superior cuff tears. Int J Shoulder Surg 7(2):79–82. https://doi.org/10.4103/0973-6042.114223 CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Paribelli G, Boschi S, Randelli P, Compagnoni R, Leonardi F, Cassarino AM (2015) Clinical outcome of latissimus dorsi tendon transfer and partial cuff repair in irreparable postero-superior rotator cuff tear. Musculoskelet Surg 99(2):127–132. https://doi.org/10.1007/s12306-015-0353-4 CrossRefPubMedGoogle Scholar
- 15.Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 304:78–83Google Scholar
- 16.Hamada K, Fukuda H, Mikasa M, Kobayashi Y (1990) Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res 254:92–96Google Scholar
- 18.Valenti P, Maqdes A, Werthel JD (2017) Clinical and radiological outcomes after reverse shoulder arthroplasty in patients with failed deltoid or latissimus dorsi transfers. A review of ten cases. Int Orthop. https://doi.org/10.1007/s00264-017-3520-4
- 27.Codsi MJ, Hennigan S, Herzog R, Kella S, Kelley M, Leggin B, Williams GR, Iannotti JP (2007) Latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears. Surgical technique. J Bone Joint Surg Am 89(Suppl 2):Pt.1:1–Pt.1:9. https://doi.org/10.2106/JBJS.F.01160 CrossRefGoogle Scholar