Latissimus dorsi tendon transfer for irreparable rotator cuff tears: a modified technique using arthroscopy

Area of Science:

• Orthopedic Surgery
• Shoulder Reconstruction
• Arthroscopy

Background:

• Massive irreparable rotator cuff tears often require complex surgical interventions.
• Traditional latissimus dorsi transfer techniques can involve significant soft tissue disruption.
• Preserving deltoid function is crucial for optimal shoulder biomechanics post-surgery.

Purpose of the Study:

• To describe a novel arthroscopically assisted latissimus dorsi transfer technique.
• To evaluate a method that minimizes deltoid muscle insult during the procedure.
• To provide a reproducible surgical approach for treating posterosuperior massive irreparable rotator cuff tears.

Main Methods:

• The procedure utilizes an arthroscopically assisted approach with the patient in the lateral decubitus position.
• An L-shaped incision facilitates access to the latissimus dorsi and teres major muscles.
• The latissimus tendon is mobilized via dissection to the thoracodorsal neurovascular pedicle and transferred arthroscopically through a subdeltoid tunnel.

Main Results:

• The described technique allows for arthroscopic transfer and stabilization of the latissimus tendon.
• The method aims to avoid direct insult to the deltoid muscle.
• Suture anchors are used for arthroscopic stabilization to the infraspinatus and supraspinatus footprints.

Conclusions:

• Arthroscopically assisted latissimus dorsi transfer offers a viable alternative for managing massive irreparable rotator cuff tears.
• This technique may help preserve deltoid function by minimizing surgical trauma.
• Further studies are warranted to assess the long-term outcomes and efficacy of this approach.