title: Latissimus dorsi tendon transfer for irreparable rotator cuff tears: a systematic review.
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.
authors.affiliation: Department of Orthopaedic Surgery, University of Pennsylvania, 3400 Spruce Street, 2 Silverstein Building, Philadelphia, PA 19104, USA.
authors.forename: Surena
authors.initials: S
authors.lastname: Namdari
authors.forename: Pramod
authors.initials: P
authors.lastname: Voleti
authors.forename: Keith
authors.initials: K
authors.lastname: Baldwin
authors.forename: David
authors.initials: D
authors.lastname: Glaser
authors.forename: G Russell
authors.initials: GR
authors.lastname: Huffman
mesh_terms: D000367:Age Factors; D001182:Arthroscopy / Q000379:methods; D006801:Humans; D053580:Muscle Strength; D010147:Pain Measurement; D010369:Pectoralis Muscles / Q000637:transplantation*; D016059:Range of Motion, Articular / Q000502:physiology; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013708:Tendon Injuries / Q000601:surgery*; D013709:Tendon Transfer / Q000379:methods*