Outcomes of Arthroscopic-Assisted Latissimus Dorsi Transfer for Irreparable Posterosuperior Rotator Cuff Tears

Abstract

Introduction: Therapeutic options for the treatment of irreparable posterosuperior rotator cuff tears, particularly in younger, active patients, are limited. Arthroscopic-assisted transfer of the Latissimus Dorsi represents a promising treatment option. Materials and Methods: We report a retrospective review of 17 patients. The results were evaluated with an average follow-up of 26 months using objective criteria (Constant score) and subjective measures (Subjective Shoulder Value (SSV), visual analog scale (VAS), satisfaction level). Results: The study group consisted of 9 men and 8 women. The average age at the time of the intervention was 56.4 years (range: 44-66 years). At the last follow-up, the absolute Constant score had significantly improved, increasing from an average of 32.6 preoperatively to 64.3 postoperatively (P<0.001), with a significant improvement in all domains (P<0.001). Active anterior elevation increased from 95.29° to 141.17°, and the average improvement in external rotation (ER) was 14°. The VAS pain score decreased from 6.3 preoperatively to 1.8 postoperatively (P<0.001). Subjectively, 77% of the patients reported being very satisfied or satisfied, and eight out of nine patients were able to resume their work. Discussion and Conclusion: Arthroscopic-assisted transfer of the Latissimus  dorsi tendon allows for satisfactory functional outcomes in young and active patients with posterosuperior rotator cuff injury. The results are similar to those reported in open surgery series. However, identifying predictors of better outcomes is essential to facilitate patient selection.