title: Outcome of latissimus dorsi transfer as a salvage procedure for failed rotator cuff repair with loss of elevation.
abstract: Eighteen patients, referred from an outside institution with massive, irreparable rotator cuff tears and loss of elevation, were treated with a latissimus dorsi tendon transfer as a salvage procedure for failed, prior, attempted rotator cuff repair. Clinical outcomes were measured by the American Shoulder and Elbow Surgeon's (ASES) score, pain level, and active range of motion. The average postoperative ASES score was 61, an increase from 43 pre-operatively (P = .05). Active elevation improved to an average of 137 degrees compared to 56 degrees pre-operatively (P < .001). The average post-operative pain level was 22 mm, down from 59 (P = .001), and the average post-operative active external rotation at the side was 45 degrees, improved from 31 degrees (P < .001). We conclude that latissimus transfer, as a salvage procedure for failed rotator cuff repair with loss of elevation, allows for significant return of active elevation and function with minimal post-operative pain.
authors.affiliation: Department of Orthopaedic Surgery, George Washington University, Washington, DC 20037, USA. birmingham@HSS.edu
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Birmingham
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Neviaser