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

• Published in: Arthroscopy Vol. 33; no. 5; pp. 929 - 937
• Main Authors: Kanatlı, Ulunay, M.D, Özer, Mustafa, M.D, Ataoğlu, Muhammet Baybars, M.D, Öztürk, Burak Yağmur, M.D, Gül, Orkun, M.D, Çetinkaya, Mehmet, M.D, Ayanoğlu, Tacettin, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2017
• Subjects: Aged; Female; Follow-Up Studies; Humans; Male; Middle Aged; Orthopedics; Paralysis - surgery; Postoperative Period; Range of Motion, Articular; Rotation; Rotator Cuff - surgery; Rotator Cuff Injuries - surgery; Rotator Cuff Injuries - therapy; Severity of Illness Index; Superficial Back Muscles - surgery; Tendon Transfer - methods; Treatment Outcome
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2016.09.023

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.