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Review
. 2017 Feb 28:11:77-94.
doi: 10.2174/1874325001711010077. eCollection 2017.

Latissimus Dorsi Transfer in Posterior Irreparable Rotator Cuff Tears

Panagiotis P Anastasopoulos  1 , George Alexiadis  1 , Sarantis Spyridonos  1 , Emmanouil Fandridis  1
Affiliations
Review

Latissimus Dorsi Transfer in Posterior Irreparable Rotator Cuff Tears

Panagiotis P Anastasopoulos et al. Open Orthop J. .

Abstract

Background: Massive rotator cuff tears pose a difficult and complex challenge even for the experienced surgeon; inability to repair these tears by conventional means designates them as irreparable, while management becomes quite taxing. Several operative options have been suggested for the management of such lesions with varying degrees of success, while it is imperative to match patient demands and expectations to the predicted outcome.

Methods: Research articles are examined and key concepts are discussed, in order to provide an evidence based review of the available literature. The anatomy and pathomechanics along with the indications, contraindications and surgical techniques are reported.

Results: Transfer of the Latissimus dorsi has been used with success to restore shoulder function in deficits of the posterior rotator cuff. Although it can be used in a variety of settings, the ideal patient for a Latissimus dorsi tendon transfer is a young and active individual, with no glenohumeral osteoarthritis that has a severe disability and weakness related to an irreparable posterior cuff tear.

Conclusion: Tendon transfers have proved to be a successful treatment option in salvaging this difficult problem, providing pain relief and restoring shoulder function. Despite the excellent functional outcomes and pain suppression following operation, a variety of factors may affect the outcome; thus making indications and preoperative assessment a valuable component.

Keywords: Irreparable rotator cuff tears; Latissimus dorsi; Massive rotator cuff tears; Shoulder surgery; Tendon; Transfer.

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Figures

Fig. (1)
Fig. (1)
Superior approach with an incision 1 cm medial to the lateral border of the acromion.
Fig. (2)
Fig. (2)
Axillary approach on the lateral border of the latissimus dorsi.
Fig. (3)
Fig. (3)
Dissection of the pedicle and separation of the latissimus dorsi tendon.
Fig. (4)
Fig. (4)
Preparation of the denuded supraspinatus footprint for fixation of latissimus dorsi with anchors.
Fig. (5)
Fig. (5)
Transfer of the latissimus dorsi tendon by pulling the sutures through an anterior portal.
Fig. (6)
Fig. (6)
Anchor fixation of the latissimus dorsi over the supraspinatus footprint.
See this image and copyright information in PMC

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