How to Manage Failed Rotator Cuff Repair: Latissimus Dorsi Transfer
The “evidence based” medicine and the attention to the analysis of the results demonstrate the ineffectiveness of techniques based on direct repair of the rotator cuff documenting the failures or the recurrences in many massive injuries, even when at the time of surgery the tendons appear firmly repaired to the bone. The search for effective alternatives to direct repair led to consider the muscle-tendon transfers. The open technique for latissimus dorsi transfer (LDT) described by Gerber has been the gold standard for many years. More recently an arthroscopically assisted technique has been introduced by Gervasi. On the basis of the currently available data, all patients who underwent LDT improved in clinical and functional scores compared to preoperative condition. Therefore, LDT might be a viable option in case of massive posterosuperior lesion of the rotator cuff with muscle atrophy even in revision cases.
KeywordsMuscle transfer Latissimus dorsi Posterosuperior cuff Irreparable tears Arthroscopic transfer
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