Latissimus Dorsi Tendon Transfer and Superior Capsular Reconstruction For Irreparable, Posterosuperior Rotator Cuff Tears

Abstract

Background: The purpose of this study was to compare latissimus dorsi tendon transfer (LDTT) and arthroscopicsuperior capsular reconstruction (SCR) to determine if one is superior to the other regarding improvement in range ofmotion (ROM) or patient-reported outcomes (PROs).Methods: A multicenter, retrospective cohort study was conducted on 43 patients with an irreparable, posterosuperiorrotator cuff tear who underwent either LDTT or SCR. Preoperative and postoperative forward flexion and externalrotation, as well as PROs including ASES, VAS, and SSV, were assessed. Student t-test and chi-square statisticalanalyses were performed.Results: 16 LDTT, at mean follow-up of 18 months, and 27 SCR, at mean follow-up 15 months, were studied. Mean activeforward flexion significantly improved from 85.2° to 137.6° in the SCR cohort (P=0.001). SCR patients demonstrated asignificantly greater increase in forward flexion as compared to LDTT patients (52.4° vs 14.1°, P=0.001). Mean activeexternal rotation amongst the LDTT group significantly improved from 41.7° to 61.5° (P=0.032). LDTT demonstratedsignificantly greater improvement in external rotation as compared to SCR (19.4° vs 0.8°, P=0.011). There were nosignificant differences in reported ASES, VAS, or SSV scores.Conclusion: This study demonstrates successful clinical and patient-reported outcomes with both LDTT and SCRfor irreparable, posterosuperior rotator cuff tears, with greater improvement in forward flexion with SCR and greaterimprovement in external rotation with LDTT.Level of evidence: III