Treatment of irreparable rotator cuff tears by latissimus dorsi muscle transfer.

In this retrospective study, a latissimus dorsi transfer as first described by Gerber in 1988 was performed in 12 patients with massive, irreparable rotator cuff tears. Their average age was 59 years and the preliminary results are reported here after an average follow-up of 39 months. In 50% of the patients there was no pain and 41% had mild to moderate pain at follow-up. Functional Constant scoring was excellent in 42%, good in 8%, moderate in 42% and poor in 8%. Active range of motion in the shoulder improved significantly in external rotation and abduction. Abduction force as measured with Atlantech and Cybex systems showed weak results. In two patients these tests could not be performed due to lack of force, in 9 patients abduction force was much weaker than on the contralateral side and in one patient the operated arm was stronger than the other side. We conclude that in most patients good pain relief and functional improvement can be achieved after latissimus dorsi transfer for irreparable rotator cuff tear. A good active range of motion can be expected but a lack of force persists. However, it remains difficult to conclude for which patients this surgery can be predictably successful.