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Arthroscopic-assisted Latissimus Dorsi Tendon Transfer for the Management of Irreparable Rotator Cuff Tears in Middle-aged Physically Active Patients
Clin Should Elbow 2019;22:9-15
Published online March 1, 2019;  https://doi.org/10.5397/cise.2019.22.1.9
© 2019 Korean Shoulder and Elbow Society.

Tae Kang Lim , Kyu Hwan Bae

Department of Orthopedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
Correspondence to: Tae Kang Lim
Department of Orthopedic Surgery, Eulji Hospital, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea
Tel: +82-2-970-8036, Fax: +82-2-973-3024, E-mail: fromspace@daum.net, ORCID: https://orcid.org/0000-0001-8752-3987
IRB approval: Eulji Hospital, Eulji University School of Medicine (EMCS 2018-07-030).
Received September 29, 2018; Revised November 21, 2018; Accepted December 2, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Latissimus dorsi (LD) tendon transfer is used as a treatment option for massive irreparable posterosuperior rotator cuff
tears, and recently, an arthroscopic-assisted technique was introduced. This study was undertaken to evaluate the clinical and radiological outcomes of arthroscopic-assisted LD tendon transfer for the management of irreparable rotator cuff tears in active middle-aged patients.
Methods: The records of five patients (two males) with irreparable tears involving the supraspinatus and infraspinatus tendons managed by arthroscopic-assisted LD tendon transfer were retrospectively reviewed. Clinical outcomes were assessed using the visual analogue scale (VAS) pain scale, American Shoulder and Elbow Surgeon셲 (ASES) scores, the University of California Los Angeles (UCLA) scale, and ranges of motion. Postoperative integrities of transferred tendon were evaluated by magnetic resonance imaging in 4 patients and by ultrasound in one.
Results: Mean patient age was 55 years (range, 48–61 years), and mean follow-up period was 20 months (range, 12.0–27.2 months).
Mean VAS score significantly improved from 6.6 짹 2.6 preoperatively to 1.8 짹 2.5 postoperatively (p=0.009), mean ASES score increased from 67.6 짹 9.2 to 84.6 짹 15.1, and mean UCLA score from 18.0 짹 1.4 to 28.8 짹 8.5 (all p<0.001). Postoperative imaging of the transferred LD tendon showed intact repair in 4 patients. The remaining patient experienced LD transfer rupture and a poor outcome.
Conclusions: Arthroscopic-assisted LD tendon transfer improved shoulder pain and function in patients with massive, irreparable rotator cuff tears, and may be an option for this condition, especially in physically active patients.
Keywords : Irreparable; Rotator cuff tear; Latissimus dorsi; Arthroscopic; Tendon transfer