DOS Kongressen 2014 ·
103
Latissimus Dorsi Tendon Transfer for Irreparable
Posterosuperior Rotator Cuff Tears. A retrospective
study of 38 Cases
Magnús Pétur Bjarnason Obinah, Theis Muncholm Thillemann, Janne Ovesen,
Brian Elmengaard, Hans Viggo Skjeldborg Johannsen
Shoulder and Elbow Unit, Department of Orthopaedic Surgery, Aarhus
University Hospital
Background:
Latissimus Dorsi Transfer (LDT) was proposed by Gerber in 1988
for treating irreparable posterosuperior rotator-cuff tears involving the su-
praspinatus and infraspinatus. These injuries can cause superior migration of the
humeral head, which may lead to glenohumeral cartilage degeneration due to
excentric wear, and ultimately cuff tear arthropathy.
Purpose / Aim of Study:
The aim of this retrospective study was to evaluate
the 1-11 years results after LDT in a consecutive series of 38 cases.
Materials and Methods:
We included 38 LDT procedures in 38 patients treat-
ed in the period from 2003-2013. Pre- and peroperative information was col-
lected by review of medical reports. The primary outcome was failure defined as
graft rupture or revision surgery (shoulder arthroplasty). Secondary outcomes
obtained at follow-up included range of motion (ROM), Constant score, Oxford
Shoulder Score (OSS), simple shoulder value (SSV) and radiographic evaluation.
Findings / Results:
Mean follow-up was 76.5 months (19 - 137). Mean age
at operation was 58,3 (49 – 69). Eight patients had revision surgery, with a
median interval between index and revision surgery of 45 months (8 – 96).
One patient had a graft-failure. The cumulative 5 year survival rate was 83,9%
(95% CI: 67,5 – 92,4). At follow-up mean active flexion was 105º (95% CI: 85
– 126), abduction 102º (95% CI: 81 – 122) and external rotation 28º (95%
CI: 21 – 34). Mean Constant score was 44 (95% CI: 37 – 50), mean OSS was
32 (95% CI: 28-37) and mean SSV was 50 (95% CI: 39 – 60). When asked if
they would choose a LDT again if given the same preoperative circumstances;
90% answered yes.
Conclusions:
Latissimus Dorsi Transfer is a satisfactory treatment for irrepa-
rable posterosuperior rotator-cuff tears. At long term follow-up we found ac-
ceptable functional outcome and pain relief with good overall patient satisfac-
tion.
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