Arthroscopic-Assisted Latissimus Dorsi Tendon Transfer for Massive, Irreparable Rotator Cuff Tears: Technique and Short-Term Follow-Up of Patients With Pseudoparalysis

KANATLI U., ÖZER M., ATAOĞLU M. B., Ozturk B. Y., Gul O., Cetinkaya M., ...More

ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, vol.33, no.5, 2017 (SCI-Expanded) identifier identifier identifier


Purpose: To describe a modified technique for arthroscopic-assisted transfer of the latissimus dorsi tendon in a selected group of patients with irreparable rotator cuff tears and pseudoparalysis and to evaluate its short-term results. Methods: Fifteen patients with irreparable rotator cuff tears and pseudoparalysis treated by arthroscopic-assisted latissimus dorsi tendon transfer were included. The mean patient age was 61.53 +/- 6.24 years (range, 52-71 years). Patients were assessed with physical examination, University of California Los Angeles (UCLA) Score and Constant-Murley score, as well as visual analog scale score at a mean follow-up of 26.4 +/- 2.58 months (range, 24-31 months). Results: At final follow-up, mean UCLA score increased to 27.47 +/- 6.31 compared with the preoperative UCLA score of 6.53 +/- 2.1 (P < .001). Constant-Murley score was 21 +/- 7.41 and 59.73 +/- 13.62 (P < .001), visual analog scale pain score was 7.47 +/- 1.06 and 2.47 +/- 0.91 (P < .001), active forward flexion was 58 degrees +/- 21.11 degrees and 130 degrees +/- 30.05 degrees (P < .001), active abduction was 51 degrees +/- 1.64 degrees and 129.67 degrees +/- 25.45 degrees (P <.001), and active external rotation was 13.33 degrees +/- 21.68 degrees and 32 degrees +/- 18.03 degrees (P < .001) preoperatively and postoperatively, respectively. Mean acromiohumeral distance was 3.13 +/- 1.40 mm preoperatively, whereas it was 5.67 +/- 1.67 mm postoperatively (P < .001). No significant complications requiring a revision surgery was observed during the final follow-up. Conclusions: The modified technique of arthroscopic-assisted transfer of the latissimus dorsi tendon is a feasible, minimally invasive option for the surgical treatment of irreparable rotator cuff tears in a subset of patients with pseudoparalysis.