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. 2018 Mar 1;100-B(3):309-317.
doi: 10.1302/0301-620X.100B3.BJJ-2017-0920.R1.

Teres major tendon transfer in the treatment of irreparable posterosuperior rotator cuff tears: long-term improvement of shoulder function and pain reduction at eight to 12 years’ follow-up

A Kolk  1 , J F Henseler  1 , F J Overes  1 , J Nagels  1 , R G H H Nelissen  1
Affiliations

Teres major tendon transfer in the treatment of irreparable posterosuperior rotator cuff tears: long-term improvement of shoulder function and pain reduction at eight to 12 years’ follow-up

A Kolk et al. Bone Joint J. .

Abstract

Aims: Since long-term outcome of teres major tendon transfer surgery for irreparable posterosuperior rotator cuff (RC) tears is largely unknown, the primary aim of this study was to evaluate the long-term outcome of the teres major transfer. We also aimed to report on the results of a cohort of patients with a similar indication for surgery that underwent a latissimus dorsi tendon transfer.

Patients and methods: Patients and Methods In this prospective cohort study, we reported on the long-term results of 20 consecutive patients with a teres major tendon transfer for irreparable massive posterosuperior RC tears. Additionally, we reported on the results of the latissimus dorsi tendon transfer (n = 19). The mean age was 60 years (47 to 77). Outcomes included the Constant score (CS), and pain at rest and during movement using the Visual Analogue Scale (VAS).

Results: At a mean of ten years (8 to 12) following teres major transfer, the CS was still 23 points (95% confidence interval (CI) 14.6 to 30.9, p < 0.001) higher than preoperatively. VAS for pain at rest (21 mm, 95% CI 4.0 to 38.9, p = 0.016) and movement (31 mm, 95% CI 16.0 to 45.1, p < 0.001) were lower than preoperatively. We also found an increase in CS (32 points, 95% CI 23.4 to 40.2, p < 0.001) and reduction of pain (26 mm, 95% CI 9.9 to 41.8, p = 0.001) six years after latissimus dorsi transfer.

Conclusion: Teres major tendon transfer is a treatment option to gain shoulder function and reduce pain in patients with an irreparable posterosuperior RC tear at a mean follow-up of ten years. The teres major tendon might be a valuable alternative to the commonly performed latissimus dorsi tendon transfer in the treatment of irreparable posterosuperior RC tears. Cite this article: Bone Joint J 2018;100-B:309-17.

Keywords: Massive rotator cuff tear; Pain; Quality of life; Shoulder; Surgery; Tendon transfer.

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