Latissimus Dorsi Tendon Transfer for the Treatment of Irreparable Rotator Cuff Tears

Park,  Jin Soo; Choi,  Soo Joong; Noh,  Kyu Chul; Kim,  Seong Yeon; Kim,  Hong Kyun; Hwang,  Ji Hyo; Bae,  Ki Nam

doi:2016.21.4.181

Arch Hand Microsurg > Volume 21(4); 2016 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2016;21(4):181-188.
Published online December 30, 2016.
DOI: https://doi.org/10.12790/jkssh.2016.21.4.181

Latissimus Dorsi Tendon Transfer for the Treatment of Irreparable Rotator Cuff Tears

Jin Soo Park, Soo Joong Choi, Kyu Chul Noh, Seong Yeon Kim, Hong Kyun Kim, Ji Hyo Hwang, Ki Nam Bae

¹Department of Orthopaedic Surgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
²Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. csjwillow@gmail.com

Received: 20 June 2016 • Revised: 25 September 2016 • Accepted: 30 September 2016

Abstract

Purpose
Massive and irreparable rotator cuff tears present a difficult treatment problem, and if further progressed, then cuff tear arthropaty may develop. We treated seven cases of massive rotator cuff tears with latissimus dorsi tendon transfer and report their clinical results.

Methods
Seven patients of mean age of 64 years (range, 51-70 years) with irreparable massive rotator cuff tears were treated using latissimus dorsi tendon transfer. The latissimus dorsi flap was harvested through an axillary approach and reattached on the greater tuberosity, using transosseous suture with non-absorbable sutures. Outcomes were assessed clinically and radiographically after an average of 48 months (range, 28-68 months).

Results
The VAS pain scores improved from 6.3 to 3.3 points (p=0.019). Forward flexion increased from 62° to 105°, abduction increased from 49° to 94°, and external rotation increased from 15° to 34°. Postoperative antero-posterior radiography revealed a mean 0.1 mm depression of the humeral head, without statistical the mean American Shoulder and Elbow Surgeons score improved from 44 to 76. The acromiohumeral distance showed slight increase in amount of 0.1 mm without statistical significance. There was no complication.

Conclusion
Latissimus dorsi transfer is a useful surgical option for treating irreparable massive rotator cuff tears.