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Time-dependent changes after latissimus dorsi transfer: tenodesis or tendon transfer?
Ali Erşen1, Hakan Ozben, Mehmet Demirhan
1Department of Orthopaedics and Traumatology, Istanbul Medical Faculty, Istanbul University, Capa, Fatih, 34093, Istanbul, Turkey.
Clinical Orthopaedics and Related Research
|July 9, 2014
Summary
Latissimus dorsi tendon transfer can improve shoulder function in massive rotator cuff tears. However, functional gains may decrease over time, potentially delaying the need for shoulder replacement surgery.
Area of Science:
- Orthopedic Surgery
- Shoulder Reconstruction
- Rotator Cuff Repair
Background:
- Latissimus dorsi tendon transfer is an option for active patients with massive rotator cuff tears.
- Its effectiveness in preventing cuff tear arthropathy progression is not well understood.
Purpose of the Study:
- To determine if early postoperative functional improvements after latissimus dorsi tendon transfer for irreparable rotator cuff tears are sustained long-term.
- To assess functional outcomes at 1-5 years post-surgery.
Main Methods:
- 11 patients with massive, irreparable rotator cuff tears underwent latissimus dorsi tendon transfer.
- Follow-up ranged from 12 to 62 months.
- Evaluated shoulder motion, pain (VAS), and radiographic signs of arthropathy (Hamada classification).
Main Results:
- Shoulder motion and Constant-Murley scores improved at 6 months and were maintained.
- American Shoulder and Elbow Surgeons scores and pain (VAS) showed a decline from 6 months to final follow-up.
- Acromiohumeral distance increased initially but returned to preoperative levels; arthropathy progression was minimal.
Conclusions:
- Latissimus dorsi tendon transfer can improve shoulder function in massive rotator cuff tears.
- A potential loss of tenodesis effect over time may lead to arthropathy progression.
- This procedure may delay the need for reverse shoulder arthroplasty.
