Comparison of Anterior and Posterior Transfer of Latissimus Dorsi Tendon to Humeral Head in Patients with Massive and Irreparable Rotator Cuff Tear

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopedics, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

2 Department of orthopedic surgery, Hamadan University of medical sciences, Hamadan, Iran

3 Social Medicine Department, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

Abstract

Objectives: Latissimus dorsi tendon transfer is a treatment option in patients with irreparable rotator 
cuff tears. This study aimed to compare the effectiveness and safety of anterior and posterior transfer 
of latissimus dorsi tendon for anterosuperior or posterosuperior massive irr eparable rotator cuff tears.
Methods: In this prospective clinical trial, 27 patients with irreparable rotator cuff tears were treated with latissimus 
dorsi transfer. The transfers in 14 and 13 patients were from the anterior for anterosuperior cuff deficiency (group 
A) and from the posterior for posterosuperior cuff deficiency (group B), respectively. Pain, shoulder range of motion 
in forward elevation, abduction, external rotation, and functional scores were evaluated 12 months after the surgery.
Results: Two and one patients were excluded from the study due to not referring in time for follow-up and infection, 
respectively. Therefore, 13 patients remained in group A and 11 patients in group B. Visual analog scale scores 
decreased from 6.5 to 3.0 in group A (P=0.016) and from 5.909 to 2.818 in group B (P=0.028). The constant scores 
improved from 41 to 50.2 (P=0.010) in group A and from 30.2 to 42.5 (P=0.001) in group B. There was a significant 
improvement in the abduction and forward elevation in both groups which was more significant in group B. The 
posterior transfer made significant improvement in external rotation; however, the anterior transfer did not change 
external rotation. No radial or axillary nerve injury was observed in any of the two groups.
Conclusion: Latissimus dorsi transfer in patients with irreparable rotator cuff tears has a significant effect on 
recovery. It improves shoulder function and range of motion and reduces pain. Improvement of shoulder elevation 
and abduction is more significant in posterior transfer. The anterior transfer is as safe as the posterior transfer for 
nerve injury.
 Level of evidence: II

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The Archives of Bone and Joint Surgery
Volume 11, Issue 4
April 2023
Pages 236-240

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History

  • Receive Date: 14 October 2022
  • Revise Date: 14 January 2023
  • Accept Date: 17 January 2023
  • First Publish Date: 06 March 2023

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