Latissimus dorsi tendon transfer for irreparable rotator cuff tears: A systematic review

Surena Namdari, Pramod B. Voleti, Keith Baldwin, David Glaser, G. Russell Huffman

Research output: Contribution to journalReview article

71 Citations (Scopus)

Abstract

Background: Massive and irreparable posterior-superior rotator cuff tears present a difficult treatment problem. The purpose of this systematic review was to critically examine the outcomes of latissimus dorsi tendon transfers for the treatment of irreparable rotator cuff tears. Methods: A systematic review of the literature was performed via a search of electronic databases. Two reviewers independently assessed the methodological quality of, and extracted relevant data from, each included study. In cases in which the outcomes data were similar between studies, data were pooled for the purposes of generating summary outcomes through the use of frequency-weighted values. Results: Ten studies that fulfilled all inclusion and exclusion criteria were included. The frequency-weighted mean age was 58.7 years. Patients were followed for a frequency-weighted mean of 45.5 months (range, twenty-four to 126 months). Patients had a frequency-weighted mean adjusted Constant score of 45.9 preoperatively compared with 73.2 postoperatively (p < 0.001). The frequency-weighted mean active forward elevation improved from 101.9° preoperatively to 137.4° postoperatively (p < 0.001), and the frequency-weighted mean active external rotation improved from 16.8° to 26.7° (p < 0.001). Subscapularis muscle insufficiency, advanced teres minor muscle atrophy, and the need for revision surgery were correlated with poor functional outcomes in some studies. Conclusions: Compiled data and frequency-weighted means demonstrated improvement in shoulder function, range of motion, strength, and pain relief after latissimus dorsi tendon transfer for irreparable rotator cuff tears. Patients and physicians should not expect an outcome of "normal" function or complete pain relief. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)891-898
Number of pages8
JournalJournal of Bone and Joint Surgery - Series A
Volume94
Issue number10
DOIs
StatePublished - May 16 2012
Externally publishedYes

Fingerprint

Tendon Transfer
Superficial Back Muscles
Rotator Cuff
Pain
Muscular Atrophy
Articular Range of Motion
Reoperation
Therapeutics
Databases
Physicians
Muscles
Rotator Cuff Injuries

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Latissimus dorsi tendon transfer for irreparable rotator cuff tears : A systematic review. / Namdari, Surena; Voleti, Pramod B.; Baldwin, Keith; Glaser, David; Huffman, G. Russell.

In: Journal of Bone and Joint Surgery - Series A, Vol. 94, No. 10, 16.05.2012, p. 891-898.

Research output: Contribution to journalReview article

Namdari, Surena ; Voleti, Pramod B. ; Baldwin, Keith ; Glaser, David ; Huffman, G. Russell. / Latissimus dorsi tendon transfer for irreparable rotator cuff tears : A systematic review. In: Journal of Bone and Joint Surgery - Series A. 2012 ; Vol. 94, No. 10. pp. 891-898.
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N2 - Background: Massive and irreparable posterior-superior rotator cuff tears present a difficult treatment problem. The purpose of this systematic review was to critically examine the outcomes of latissimus dorsi tendon transfers for the treatment of irreparable rotator cuff tears. Methods: A systematic review of the literature was performed via a search of electronic databases. Two reviewers independently assessed the methodological quality of, and extracted relevant data from, each included study. In cases in which the outcomes data were similar between studies, data were pooled for the purposes of generating summary outcomes through the use of frequency-weighted values. Results: Ten studies that fulfilled all inclusion and exclusion criteria were included. The frequency-weighted mean age was 58.7 years. Patients were followed for a frequency-weighted mean of 45.5 months (range, twenty-four to 126 months). Patients had a frequency-weighted mean adjusted Constant score of 45.9 preoperatively compared with 73.2 postoperatively (p < 0.001). The frequency-weighted mean active forward elevation improved from 101.9° preoperatively to 137.4° postoperatively (p < 0.001), and the frequency-weighted mean active external rotation improved from 16.8° to 26.7° (p < 0.001). Subscapularis muscle insufficiency, advanced teres minor muscle atrophy, and the need for revision surgery were correlated with poor functional outcomes in some studies. Conclusions: Compiled data and frequency-weighted means demonstrated improvement in shoulder function, range of motion, strength, and pain relief after latissimus dorsi tendon transfer for irreparable rotator cuff tears. Patients and physicians should not expect an outcome of "normal" function or complete pain relief. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

AB - Background: Massive and irreparable posterior-superior rotator cuff tears present a difficult treatment problem. The purpose of this systematic review was to critically examine the outcomes of latissimus dorsi tendon transfers for the treatment of irreparable rotator cuff tears. Methods: A systematic review of the literature was performed via a search of electronic databases. Two reviewers independently assessed the methodological quality of, and extracted relevant data from, each included study. In cases in which the outcomes data were similar between studies, data were pooled for the purposes of generating summary outcomes through the use of frequency-weighted values. Results: Ten studies that fulfilled all inclusion and exclusion criteria were included. The frequency-weighted mean age was 58.7 years. Patients were followed for a frequency-weighted mean of 45.5 months (range, twenty-four to 126 months). Patients had a frequency-weighted mean adjusted Constant score of 45.9 preoperatively compared with 73.2 postoperatively (p < 0.001). The frequency-weighted mean active forward elevation improved from 101.9° preoperatively to 137.4° postoperatively (p < 0.001), and the frequency-weighted mean active external rotation improved from 16.8° to 26.7° (p < 0.001). Subscapularis muscle insufficiency, advanced teres minor muscle atrophy, and the need for revision surgery were correlated with poor functional outcomes in some studies. Conclusions: Compiled data and frequency-weighted means demonstrated improvement in shoulder function, range of motion, strength, and pain relief after latissimus dorsi tendon transfer for irreparable rotator cuff tears. Patients and physicians should not expect an outcome of "normal" function or complete pain relief. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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