Skip to main content

Advertisement

SpringerLink
Log in

Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

The objective of this paper was to determine the outcome of the transfer of the latissimus dorsi tendon in patients with massive irreparable rotator cuff tears. Eighteen patients of mean age 54 years (range 37–72 years) with massive irreparable rotator cuff tears were studied. The mean follow-up was 28 months (range 12–58 months). The postoperative Constant score was higher by an average of 21.15 points compared to the preoperative score (P=0.002); 88.8% of patients reported significant pain relief and improved mobility, particularly on external rotation. Postoperative resting antero-posterior radiography in neutral rotation revealed a mean 3.2-mm depression of the humeral head, due to the tenodesis effect of tendon transfer, thus, increasing the deltoid lever arm. These clinical results suggest that latissimus dorsi transfer is a useful surgical technique for treating massive irreparable postero-superior tears of the rotator cuff in young and/or active patients, providing significant pain relief and improved shoulder strength.

Résumé

Déterminer le devenir des transferts du grand dorsal réalisé chez les patients avec rupture massive irréparable de la coiffe des rotateurs. 18 patients d’âge moyen 54 ans (allant de 37 à 72 ans) avec une rupture massive irréparable de la coiffe des rotateurs. Le suivi moyen était de 28 mois (allant de 12 à 58 mois). le score de Constant post-opératoire était amélioré en moyenne de 21,15 points par rapport au score préopératoire (P=0,002); 88,8% des patients rapportaient une amélioration significative de la douleur et de la mobilité en particulier sur la rotation externe. Les radios postopératoires de face au repos, en position neutre, montraient un abaissement moyen de 3,2 mm de la tête humérale dû à l’effet ténodèse du transfert tendineux augmentant ainsi le bras de levier du deltoïde. Ces résultats cliniques suggèrent que le transfert du grand dorsal est une technique efficace pour le traitement des ruptures massives de la coiffe des rotateurs chez les patients jeunes et/ou actifs amenant une réduction significative de la douleur et une augmentation de la force de l’épaule.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Aldridge JM 3rd, Atkinson TS, Mallon WJ (2004) Combined pectoralis major and latissimus dorsi tendon transfer for massive rotator cuff deficiency. J Shoulder Elbow Surg 13:621–629

    Article  PubMed  Google Scholar 

  2. Aoki M, Okamura K, Fukushima S, Takahashi T, Ogino T (1996) Transfer of latissimus dorsi for irreparable rotator-cuff tears. J Bone Joint Surg Br 78:761–766

    PubMed  CAS  Google Scholar 

  3. Apoil A, Augereau B (1985) Réparation par lambeau deltoïdien des grandes pertes de substance de la coiffe des rotateurs de l’éépaule. Chirurgie 111:287–290

    PubMed  CAS  Google Scholar 

  4. Bigliani LU, Cordasco FA, McIlveen SJ, Musso ES (1992) Operative treatment of massive rotator cuff tears: long-term results. J Shoulder Elbow Surg 1:120–130

    Article  Google Scholar 

  5. Burkhart SS (1991) Arthroscopic treatment of massive rotator cuff tears. Clinical results and biomechanical rationale. Clin Orthop Relat Res 267:45–56

    PubMed  Google Scholar 

  6. Celli L, Rovesta C, Marongiu MC, Manzieri S (1998) Transplantation of teres major muscle for infraspinatus muscle in irreparable rotator cuff tears. J Shoulder Elbow Surg 7:485–490

    Article  PubMed  CAS  Google Scholar 

  7. Cofield RH, Parvizi J, Hoffmeyer PJ, Lanzer WL, Ilstrup DM, Rowland CM (2001) Surgical repair of chronic rotator cuff tears. A prospective long-term study. J Bone Joint Surg Am 83:71–77

    PubMed  Google Scholar 

  8. Constant CR, Murley AGH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    PubMed  Google Scholar 

  9. Fenlin JM Jr, Chase JM, Rushton SA, Frieman BG (2002) Tuberoplasty: creation of an acromiohumeral articulation—a treatment option for massive, irreparable rotator cuff tears. J Shoulder Elbow Surg 11:136–142

    Article  PubMed  Google Scholar 

  10. Gartsman GM (1995) Arthroscopic treatment of rotator cuff disease. J Shoulder Elbow Surg 4:228–241

    Article  PubMed  CAS  Google Scholar 

  11. Gerber C (1992) Latissimus dorsi transfer for the treatment of irreparable tears of the rotator cuff. Clin Orthop Relat Res 275:152–160

    PubMed  Google Scholar 

  12. Gerber C, Vinh TS, Hertel R, Hess CW (1988) Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff: a preliminary report. Clin Orthop Relat Res 232:51–61

    PubMed  Google Scholar 

  13. Goutallier D, Bernargeau J, Patte D (1989) L’évaluation par le scanner de la trophicité des muscles de la coiffe des rotateurs ayant una rupture tendineuse. Rev Chir Orthop 75(Suppl 1):126–127

    Google Scholar 

  14. Gumina S, Di Giorgio G, Perugia D, Postacchini F (2008) Deltoid detachment consequent to open surgical repair of massive rotator cuff tears. Int Orthop 32:81–84

    Article  PubMed  CAS  Google Scholar 

  15. Miniaci A, MacLeod M (1999) Transfer of the latissimus dorsi muscle after failed repair of a massive tear of the rotator cuff. A two to five-year review. J Bone Joint Surg Am 81:1120–1127

    PubMed  CAS  Google Scholar 

  16. Pagnotta A, Haerle M, Gilbert A (2004) Long-term results on abduction and external rotation of the shoulder after latissimus dorsi transfer for sequelae of obstetric palsy. Clin Orthop Relat Res 426:199–205

    Article  PubMed  Google Scholar 

  17. Rockwood CA, Williams GR, Burkhead WZ (1995) Debridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg Am 77:857–866

    PubMed  Google Scholar 

  18. Tempelhof S, Rupp S, Seil R (1999) Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg 8:296–299

    Article  PubMed  CAS  Google Scholar 

  19. Vandenbussche E, Bensaïda M, Mutschler C, Dart T, Augereau B (2004) Massive tears of the rotator cuff treated with a deltoid flap. Int Orthop 28:226–230

    Article  PubMed  Google Scholar 

  20. Walch G, Madonia G, Pozzi I, Riand N, Lévigne C (1997) Arthroscopic tenotomy of the tendon of the long head of the biceps in rotator cuff ruptures. In: Gazielly D, Gleyze P, Thomas T (eds) The cuff. Elsevier, Amsterdam, pp 350–355

    Google Scholar 

  21. Warner JJP (2001) Management of massive irreparable rotator cuff tears: the role of tendon transfer. Instr Course Lect 50:63–71

    PubMed  CAS  Google Scholar 

  22. Warner JJP, Parsons IM 4th (2001) Latissimus dorsi tendon transfer: a comparative analysis of primary and salvage reconstruction of massive, irreparable rotator cuff tears. J Shoulder Elbow Surg 10:514–521

    Article  PubMed  CAS  Google Scholar 

  23. Yamaguchi K (2001) Mini-open rotator cuff repair: an updated perspective. Instr Course Lect 50:53–61

    PubMed  CAS  Google Scholar 

  24. Yamaguchi K, Sher JS, Andersen WK, Garretson R, Uribe JW, Hechtman K, Neviaser RJ (2000) Glenohumeral motion in patients with rotator cuff tears: a comparison of asymptomatic and symptomatic shoulders. J Shoulder Elbow Surg 9:6–11

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedic, University Hospital Reina Sofia, Avenue Menendez Pidal S/N, Cordoba, 14004, Spain

    Manuel Zafra, Pedro Carpintero & Carmen Carrasco

Authors
  1. Manuel Zafra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pedro Carpintero
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carmen Carrasco
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pedro Carpintero.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zafra, M., Carpintero, P. & Carrasco, C. Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff. International Orthopaedics (SICOT) 33, 457–462 (2009). https://doi.org/10.1007/s00264-008-0536-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-008-0536-9

Keywords

Search

Navigation