title: Arthroscopic-assisted latissimus dorsi transfer for subscapularis deficiency.
abstract: Few salvage procedures have been described in case of irreparable subscapularis tear and with variable outcomes. Latissimus dorsi transfer has been widely proposed as a transfer for irreparable posterio-superior rotator cuff tear with good outcomes. The anatomic feasibility of the latissimus dorsi to reconstruct the antero-superior irreparable rotator cuff tear has been suggested, but no clinical study has ever been published. We hypothesized that it was possible to use an arthroscopic-assisted latissimus dorsi transfer to reconstruct the subscapularis function. Five patients were enrolled. A 5-7-cm axillary incision was performed to release the latissimus dorsi tendon from its humeral insertion, the teres major muscle and the apex of the scapula. Afterwards, under arthroscopic control, a 7-mm-diameter tunnel was drilled at the anterior and superior part of the humeral head with an oblique inferior and posterior direction. The tubularized latissimus dorsi tendon was introduced into the tunnel and fixed with a ZipLoop on the posterior humeral cortex. The authors show overall good experience with this technique.
  
  
  METHODS
  Level IV-a, case series.
authors.affiliation: Clinique de l'Union, 31240, Saint Jean, France. jean.kany@clinique-union.fr.
authors.forename: Jean
authors.initials: J
authors.lastname: Kany
authors.affiliation: Clinique de l'Union, 31240, Saint Jean, France.
authors.forename: Régis
authors.initials: R
authors.lastname: Guinand
authors.affiliation: Clinique de l'Union, 31240, Saint Jean, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Croutzet
authors.affiliation: Clinique Jouvenet, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Valenti
authors.affiliation: LIRCOS, Paris, France.
authors.forename: Jean David
authors.initials: JD
authors.lastname: Werthel
authors.affiliation: LIRCOS, Paris, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Grimberg
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017006:Rotator Cuff; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D064171:Superficial Back Muscles / Q000637:transplantation*; D016896:Treatment Outcome
keywords: Arthroscopy; Irreparable; Latissimus; Subscapularis; Transfer