Double tendon transfer for massive rotator cuff tear: A case report.

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Research
• Reconstructive Surgery

Background:

• Massive rotator cuff tears (MRCTs) present significant surgical challenges, often leading to poor outcomes.
• Existing literature lacks guidance on tendon transfers for combined anterior and posterior-superior irreparable rotator cuff tears.
• Patient factors like tendon retraction and fatty infiltration complicate repair.

Observation:

• A 64-year-old male with a 7-month history of shoulder pain and limited motion post-dislocation presented with MRCTs (>5 cm) of the supraspinatus, infraspinatus, and subscapularis tendons.
• The patient had significant fatty infiltration (Goutallier IV) in the affected rotator cuff muscles.
• The patient underwent an open combined transfer of the latissimus dorsi and lower trapezius tendons.

Findings:

• Postoperatively, the patient achieved a painless, functional range of motion.
• The patient could resume daily activities 2.5 years after the combined tendon transfer surgery.
• The surgical approach restored rotational strength and re-established shoulder force coupling.

Implications:

• This combined latissimus dorsi and lower trapezius tendon transfer offers a viable surgical solution for complex MRCTs.
• The technique may improve outcomes in cases previously considered untreatable with standard repair methods.
• Further research is warranted to validate this approach for a broader patient population with similar injuries.