Latissimus Dorsi Tendon Transfer and Superior Capsular Reconstruction for Irreparable, Posterosuperior Rotator Cuff Tears

Document Type : RESEARCH PAPER

Authors

1 University of Pittsburgh Medical Center, Pittsburgh, PA, USA

2 University of Maryland School of Medicine, Baltimore, MD, USA

3 Dublin Shoulder Institute, Santry, Ireland

Abstract

Background: The purpose of this study was to compare latissimus dorsi tendon transfer (LDTT) and arthroscopic
superior capsular reconstruction (SCR) to determine if one is superior to the other regarding improvement in range of
motion (ROM) or patient-reported outcomes (PROs).
Methods: A multicenter, retrospective cohort study was conducted on 43 patients with an irreparable, posterosuperior
rotator cuff tear who underwent either LDTT or SCR. Preoperative and postoperative forward flexion and external
rotation, as well as PROs including ASES, VAS, and SSV, were assessed. Student t-test and chi-square statistical
analyses were performed.
Results: 16 LDTT, at mean follow-up of 18 months, and 27 SCR, at mean follow-up 15 months, were studied. Mean active
forward flexion significantly improved from 85.2° to 137.6° in the SCR cohort (P=0.001). SCR patients demonstrated a
significantly greater increase in forward flexion as compared to LDTT patients (52.4° vs 14.1°, P=0.001). Mean active
external rotation amongst the LDTT group significantly improved from 41.7° to 61.5° (P=0.032). LDTT demonstrated
significantly greater improvement in external rotation as compared to SCR (19.4° vs 0.8°, P=0.011). There were no
significant differences in reported ASES, VAS, or SSV scores.
Conclusion: This study demonstrates successful clinical and patient-reported outcomes with both LDTT and SCR
for irreparable, posterosuperior rotator cuff tears, with greater improvement in forward flexion with SCR and greater
improvement in external rotation with LDTT.
Level of evidence: III

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