Arthroscopic‑assisted latissimus dorsi transfer for irreparable posterosuperior cuf tears: Clinical outcome of 15 patients

Abstract

Objective We analyzed the clinical and functional results of patients with irreparable posterosuperior rotator cuf tears treated with arthroscopic-assisted latissimus dorsi transfer and the clinical relevance of the addition of partial repair of the remaining cuf to the transfer. Methods This was a prospective cohort study that included patients diagnosed with irreparable massive rotator cuf tears treated by arthroscopic-assisted latissimus dorsi transfer between 2015 and 2018. Demographic characteristics, clinical and functional outcomes (Constant-Murley (CS) score and subjective shoulder value (SSV)), and the incidence of complications were evaluated. Clinical outcomes were compared between patients treated with transfer alone and transfer with partial cuf repair. Results Fifteen patients were included, with an average follow-up of 37±16 months. The median duration of symptoms before surgery was 66 weeks (24–208). A signifcant increase in forward elevation of 52° (p<0.003) and abduction of 48° (p<0.001) was obtained. The CS score increased by 48 points (p<0.001), and the SSV changed from 29% preoperatively to 70% postoperatively (p<0.001), with a signifcant decrease in the visual analog pain score from 7 to 1 (p<0.001). In 10 patients, partial repair of the rotator cuf was also performed. No statistically signifcant diferences were found in these patients compared with patients treated with transfer alone. Two patients presented complications, including transient sensitive neuropraxia of the axillary nerve and seroma, which were managed conservatively and did not afect the outcomes. Conclusion Arthroscopic-assisted latissimus dorsi transfer is a safe technique that signifcantly improves clinical and functional outcomes in selected patients. Longer follow-up and comparison with other treatment options are needed to confrm these excellent results in this group of difcult-to-treat patients.