Results of latissimus dorsi tendon transfer in primary or salvage reconstruction of irreparable rotator cuff tears

Introduction: This study intends to evaluate latissimus dorsi tendon transfer outcomes in patients with irreparable rotator cuff tears, irrespective of the fact that this procedure had been used primarily in 17 patients (Group I) or as a revision of a previously shoulder surgery in eight patients (Group II). Patients and methods: Twenty-five patients (14 males and 11 females), mean age 55.8 years were treated using this procedure. Tears involved both supraspinatus and infraspinatus in 21 cases. The latissimus dorsi flap was harvested through an axillary approach and reattached on the greater tuberosity, using suture anchors. Outcome was assessed at a mean follow-up duration of 22 months (12 to 60 months) based on objective measures (Constant and Murley scores) as well as on subjective criteria (patient's satisfaction). Results: Active forward elevation (AFE) improvement as well as external rotation and absolute Constant score gains were all significant. This amelioration was more important in patients with a preoperative AFE below 80. and this without any significant difference between group I and II. Subjectively, 84% of the Group I patients were satisfied with their outcome versus 50% of patients in Group II. Discussion and conclusion: In patients with irreparable rotator cuff tears, clinical results of latissimus dorsi tendon transfer showed significant pain level reduction, and gains in active range of motion both in forward elevation and external rotation. We did not find a significant difference between primary or revision repairs. Level of evidence: Level IV retrospective therapeutic study. (C) 2010 Elsevier Masson SAS. All rights reserved.