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

Abstract

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° ± 21.11° and 130° ± 30.05° (P < .001), active abduction was 51° ± 21.64° and 129.67° ± 25.45° (P < .001), and active external rotation was 13.33° ± 21.68° and 32° ± 18.03° (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.

Level of evidence: Level IV, therapeutic case series.