Management of Irreparable Rotator Cuff Tear: Arthroscopy-Assisted Latissimus Dorsi Tendon Transfer

  • Jiwu Chen


Latissimus dorsi tendon (LDT) transfer, first introduced into practice for the treatment of massive rotator cuff tear in 1988, is becoming increasingly popular recently. Both short- and long-term follow-up results are encouraging. Currently arthroscopy-assisted LDT transfer was introduced for its minimal invasive advantages. In this section, the aim and steps of arthroscopy-assisted LDT transfer is described.


Massive Rotator cuff tear Arthroscopy Latissimus dorsi Tendon transfer 


  1. 1.
    Reilly P, et al. Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Ann R Coll Surg Engl. 2006;88(2):116–21.CrossRefGoogle Scholar
  2. 2.
    Kircher J, et al. Autologous bridging of rotator cuff tears with a hamstring tendon patch. A cadaver feasibility study and biomechanical testing. Clin Biomech (Bristol, Avon). 2018;56:36–9.CrossRefGoogle Scholar
  3. 3.
    Rhee SM, Oh JH. Bridging graft in irreparable massive rotator cuff tears: autogenic biceps graft versus allogenic dermal patch graft. Clin Orthop Surg. 2017;9(4):497–505.CrossRefGoogle Scholar
  4. 4.
    Warner JJ. Management of massive irreparable rotator cuff tears: the role of tendon transfer. Instr Course Lect. 2001;50:63–71.PubMedGoogle Scholar
  5. 5.
    Neri BR, Chan KW, Kwon YW. Management of massive and irreparable rotator cuff tears. J Shoulder Elb Surg. 2009;18(5):808–18.CrossRefGoogle Scholar
  6. 6.
    Gerber C, Fuchs B, Hodler J. The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am. 2000;82(4):505–15.CrossRefGoogle Scholar
  7. 7.
    Cofield RH. Subscapular muscle transposition for repair of chronic rotator cuff tears. Surg Gynecol Obstet. 1982;154(5):667–72.PubMedGoogle Scholar
  8. 8.
    Henry P, et al. Arthroscopic repair for chronic massive rotator cuff tears: a systematic review. Arthroscopy. 2015;31(12):2472–80.CrossRefGoogle Scholar
  9. 9.
    Chung SW, et al. Arthroscopic repair of partial-thickness and small full-thickness rotator cuff tears: tendon quality as a prognostic factor for repair integrity. Am J Sports Med. 2015;43(3):588–96.CrossRefGoogle Scholar
  10. 10.
    Kim IB, Jung DW, Suh KT. Prediction of the irreparability of rotator cuff tears. Arthroscopy. 2018;34(7):2076–84.CrossRefGoogle Scholar
  11. 11.
    Jeong HY, et al. Factors predictive of healing in large rotator cuff tears: is it possible to predict retear preoperatively? Am J Sports Med. 2018;46(7):1693–700.CrossRefGoogle Scholar
  12. 12.
    Porcellini G, et al. Partial repair of irreparable supraspinatus tendon tears: clinical and radiographic evaluations at long-term follow-up. J Shoulder Elb Surg. 2011;20(7):1170–7.CrossRefGoogle Scholar
  13. 13.
    Lee SJ, Min YK. Can inadequate acromiohumeral distance improvement and poor posterior remnant tissue be the predictive factors of re-tear? Preliminary outcomes of arthroscopic superior capsular reconstruction. Knee Surg Sports Traumatol Arthrosc. 2018;26(7):2205–13.CrossRefGoogle Scholar
  14. 14.
    Petri M, et al. Non-operative management of rotator cuff tears. Open Orthop J. 2016;10:349–56.CrossRefGoogle Scholar
  15. 15.
    Gerber C, et al. Latissimus dorsi tendon transfer for treatment of irreparable posterosuperior rotator cuff tears: long-term results at a minimum follow-up of ten years. J Bone Joint Surg Am. 2013;95(21):1920–6.CrossRefGoogle Scholar
  16. 16.
    Kolk A, et al. Teres major tendon transfer in the treatment of irreparable posterosuperior rotator cuff tears. Bone Joint J. 2018;100-B(3):309–17.CrossRefGoogle Scholar
  17. 17.
    Gupta AK, et al. Dermal tissue allograft for the repair of massive irreparable rotator cuff tears. Am J Sports Med. 2012;40(1):141–7.CrossRefGoogle Scholar
  18. 18.
    Mihata T, et al. Biomechanical effects of acromioplasty on superior capsule reconstruction for irreparable supraspinatus tendon tears. Am J Sports Med. 2016;44(1):191–7.CrossRefGoogle Scholar
  19. 19.
    Di Benedetto ED, et al. Partial repair in irreparable rotator cuff tear: our experience in long-term follow-up. Acta Biomed. 2017;88(4-S):69–74.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Senekovic V, et al. Prospective clinical study of a novel biodegradable sub-acromial spacer in treatment of massive irreparable rotator cuff tears. Eur J Orthop Surg Traumatol. 2013;23(3):311–6.CrossRefGoogle Scholar
  21. 21.
    Gerber C, et al. Longitudinal observational study of reverse total shoulder arthroplasty for irreparable rotator cuff dysfunction: results after 15 years. J Shoulder Elb Surg. 2018;27(5):831–8.CrossRefGoogle Scholar
  22. 22.
    Gerber C, et al. Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff. A preliminary report. Clin Orthop Relat Res. 1988;232:51–61.Google Scholar
  23. 23.
    Greenspoon JA, et al. Irreparable rotator cuff tears: restoring joint kinematics by tendon transfers. Open Orthop J. 2016;10:266–76.CrossRefGoogle Scholar
  24. 24.
    Somerson JS, et al. Classifications in brief: Goutallier classification of fatty infiltration of the rotator cuff musculature. Clin Orthop Relat Res. 2016;474(5):1328–32.CrossRefGoogle Scholar
  25. 25.
    Warner JJ, et al. Diagnosis and treatment of anterosuperior rotator cuff tears. J Shoulder Elb Surg. 2001;10(1):37–46.CrossRefGoogle Scholar
  26. 26.
    Lippe J, et al. Inter-rater agreement of the Goutallier, Patte, and Warner classification scores using preoperative magnetic resonance imaging in patients with rotator cuff tears. Arthroscopy. 2012;28(2):154–9.CrossRefGoogle Scholar
  27. 27.
    Hamada K, et al. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990;254:92–6.Google Scholar
  28. 28.
    Heuberer PR, et al. Arthroscopic management of massive rotator cuff tears: an evaluation of debridement, complete, and partial repair with and without force couple restoration. Knee Surg Sports Traumatol Arthrosc. 2016;24(12):3828–37.CrossRefGoogle Scholar
  29. 29.
    Namdari S, et al. Latissimus dorsi tendon transfer for irreparable rotator cuff tears: a systematic review. J Bone Joint Surg Am. 2012;94(10):891–8.CrossRefGoogle Scholar
  30. 30.
    Nottage WM. Editorial commentary: partial (shoulder rotator) cuff repair: may the force (couple) be with you. Arthroscopy. 2017;33(11):1956–7.CrossRefGoogle Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  • Jiwu Chen
    • 1
  1. 1.Department of Sports Medicine, Huashan HospitalFudan UniversityShanghaiChina

Personalised recommendations