title: Functional status and failed rotator cuff repair predict outcomes after arthroscopic-assisted latissimus dorsi transfer for irreparable massive rotator cuff tears.
abstract: BACKGROUND
  Arthroscopic-assisted latissimus dorsi tendon transfer (LDTT) has been recently introduced for treatment of irreparable, posterosuperior massive rotator cuff tears. We sought to evaluate the functional outcomes of this technique and to check for possible outcome predictors.
  
  
  METHODS
  The study reviewed 86 patients (aged 59.8 ± 5.9 years) who underwent an arthroscopic-assisted latissimus dorsi tendon transfer after 36.4 ± 9 months of follow-up. Of these, 14 patients (16.3%) sustained an irreparable massive rotator cuff tear after a failed arthroscopic rotator cuff repair. The Constant and Murley score (CMS) was used to assess patients' functionality preoperatively and at follow-up.
  
  
  RESULTS
  As a group, the CMS improved with surgery from 35.5 ± 6.1 to 69.5 ± 12.3 (P < .001). A lower preoperative CMS and a previous failed rotator cuff repair resulted in lower postoperative range of motion (P = .044 and P = .007, respectively) and CMS (P = .042 and P = .018, respectively). A previous rotator cuff repair resulted in lower satisfaction with surgery (P = .009). Gender and age did not affect the clinical outcomes.
  
  
  CONCLUSIONS
  Our results support the effectiveness of arthroscopic-assisted LDTT in the treatment of patients with an irreparable, posterosuperior massive rotator cuff tears in pain relief, functional recovery, and postoperative satisfaction. Patients with lower preoperative CMS and a history of failed rotator cuff repair have a greater likelihood of having a lower clinical result. However, the favorable values of summary postoperative scores do not exclude these patients as candidates for arthroscopic-assisted LDTT.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Castricini
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: De Benedetto
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, Catanzaro, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Familiari
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, Catanzaro, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: De Gori
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, Catanzaro, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: De Nardo
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Orlando
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, Catanzaro, Italy. Electronic address: gasparini@unicz.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gasparini
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, Catanzaro, Italy.
authors.forename: Olimpio
authors.initials: O
authors.lastname: Galasso
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D064171:Superficial Back Muscles / Q000503:physiopathology / Q000637:transplantation*; D013708:Tendon Injuries / Q000601:surgery*; D013709:Tendon Transfer; D016896:Treatment Outcome
keywords: Arthroscopic-assisted latissimus dorsi transfer; Constant and Murley score; failed rotator cuff repair; irreparable massive rotator cuff tears; outcome predictors