Lattisimus Dorsi Transfer assisted by arthroscopy for the treatment of irreparable posterolateral Rotator Cuff Tears

Abstract

Objective:To evaluate subjective and functional mid term results of patients treated by a lattisimus dorsi tendón transfer arthroscopically assisted for massive irreparable posterolateral injuries of the Rotator Cuff.Methods:Between 2009 and 2012, 17 Lattisimus Dorsi transfers (Paribelli technique) for irreparable posterolateral rotator cuff tears were performed. Distribution by sex: 12 men and 5 women with a mean age of 53 years old (range, 40-63). Thirteen right shoulders and 4 left shoulders. Average duration of symptoms prior to surgery was 8 months (range, 6-13 months). Mean follow-up was 28 months (range, 18-44). Patients were evaluated by the VAS, satisfaction rate, the Constant Modified Scale, postoperative range of motion and strength. Postoperative radiological studies included simple AP radiographs and MRI in order to measure AC distance and asses the integrity of the plasty.Results:Postoperative Constant Modified score averaged 63.54 points. (average increase of 13 points compared to preoperative score. (P ..05)). Active Mobility: a) Mean elevation: 142° postop vs. 119° preop (p <.001). b) Mean abduction: 138.24º postop vs. 112.35º preop (p <.001). c) Mean external rotation 40° postop vs. 20.29º preop (p <.004). Insert text.Conclusion:Lattisimus Dorsi transfer in patients with posterolateral massive irreparable injuries of the RC, is a highly demanding and palliative procedure for those cases with loss of active mobility, especially lifting and shoulder abduction.