title: Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears: Short-Term Results.
abstract: BACKGROUND
  Irreparable rotator cuff tears associated with shoulder functional impairment represent a challenge, especially in young and active patients. Latissimus dorsi muscle-tendon transfer is performed to replace the irreversibly lost contractile elements in patients with irreparable tears of the posterosuperior aspect of the rotator cuff.
  
  
  METHODS
  From 2008 to 2010, we enrolled twenty-seven patients (mean age, sixty years; range, forty-six to sixty-seven years) with irreparable, full-thickness rotator cuff tears involving at least two tendons who underwent arthroscopic-assisted latissimus dorsi muscle-tendon transfer. Outcome measures included the Constant and Murley score, shoulder range of motion in external rotation, and muscle strength in forward elevation. The mean duration of follow-up was twenty-seven months (range, twenty-four to thirty-six months).
  
  
  RESULTS
  There was a significant improvement (p < 0.05) in the mean Constant and Murley score, pain score, muscle strength in forward elevation, and range of motion in external rotation at the time of the last follow-up. There was no significant correlation between the mean preoperative range of motion, pain, and strength and the mean postoperative Constant and Murley score. There was no significant osteoarthritis progression and proximal migration of the humeral head after surgery in the time period studied.
  
  
  CONCLUSIONS
  Arthroscopic-assisted latissimus dorsi muscle-tendon transfer at short-term follow-up is an effective alternative to open surgery for the management of painful irreparable posterosuperior rotator cuff tears refractory to conservative management.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Via Corriera 1, 48010 Cotignola, Ravenna, Italy. E-mail address for R. Zini: raulzini@libero.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Castricini
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy. E-mail address for U.G. Longo: g.longo@unicampus.it. E-mail address for M. Loppini: m.loppini@unicampus.it. E-mail address for V. Denaro: v.denaro@unicampus.it.
authors.forename: Umile Giuseppe
authors.initials: UG
authors.lastname: Longo
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Via Corriera 1, 48010 Cotignola, Ravenna, Italy. E-mail address for R. Zini: raulzini@libero.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: De Benedetto
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy. E-mail address for U.G. Longo: g.longo@unicampus.it. E-mail address for M. Loppini: m.loppini@unicampus.it. E-mail address for V. Denaro: v.denaro@unicampus.it.
authors.forename: Mattia
authors.initials: M
authors.lastname: Loppini
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Via Corriera 1, 48010 Cotignola, Ravenna, Italy. E-mail address for R. Zini: raulzini@libero.it.
authors.forename: Raul
authors.initials: R
authors.lastname: Zini
authors.affiliation: Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England. E-mail address: n.maffulli@qmul.ac.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy. E-mail address for U.G. Longo: g.longo@unicampus.it. E-mail address for M. Loppini: m.loppini@unicampus.it. E-mail address for V. Denaro: v.denaro@unicampus.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D000368:Aged; D001182:Arthroscopy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D064171:Superficial Back Muscles / Q000637:transplantation*; D025321:Surgery, Computer-Assisted; D013709:Tendon Transfer / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome