Open Latissimus Dorsi Transfer for Irreparable Subscapularis Tendon Tear

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Research
• Sports Medicine

Background:

• Irreparable subscapularis (SSC) tendon tears in young, active individuals often necessitate surgical intervention.
• Tendon transfers are currently the sole surgical solution for these debilitating injuries.
• The latissimus dorsi (LD) muscle is considered optimal due to its biomechanical advantages and synergistic action with the SSC.

Purpose of the Study:

• To evaluate the efficacy and safety of latissimus dorsi (LD) tendon transfer for irreparable subscapularis (SSC) tears.
• To assess functional outcomes and complication rates associated with this surgical technique.

Main Methods:

• The study describes an open LD tendon transfer procedure using a deltopectoral approach.
• Key steps include mobilization of the LD tendon, preparation of the lesser tuberosity, and secure fixation with anchors.
• The procedure also involves closing the rotator interval and stabilizing the long head of the biceps (LHB).

Main Results:

• The LD tendon transfer demonstrates a failure and revision rate between 0% and 20%, comparable to other transfer methods.
• No nerve compression complications were reported.
• Functional outcomes were significantly better when using the LD muscle compared to the pectoralis major (PM) muscle.

Conclusions:

• Open LD tendon transfer is a straightforward surgical technique yielding satisfactory short- to mid-term results for irreparable, symptomatic SSC tears.
• Long-term efficacy, especially concerning glenohumeral osteoarthritis development, requires further investigation.