Method of arthroscopically assisted latissimus dorsi tendon transfer in the “lateral decubitus” position for the treatment of patients with anterior-superior irreparable massive rotator cuff tears

Irreparable anterior-superior rotator cuff tears are less common than postero-superior cuff tears and spoted for approximately 5 to 20% of all tears [1,2]. Nowadays various "joint-saving" interventions have been described that can be used while the articular cartilage of the shoulder joint is safe. Muscle-tendon transfers are an option for young, active patients with irreparable ruptures of the rotator cuff. Biomechanicaly the transfer of the tendon of the latissimus dorsi muscle is the most beneficial intervention for the treatment of specialized patients [7, 25-27]. Given the above data, the search for methods that simplify and accelerate the procedure and increase the strength of the latissimus dorsi muscle and the reliability of its intraoperative fixation is very relevant.

The aim is to test and apply in private practice a new method of arthroscopically assisted latissimus dorsi tendon transfer for the treatment of relevant patients.

Material and methods. In the period from 2021 to 2022, 9 interventions were performed according to the method protected by the patent: “Method of surgical treatment of massive irreparable rotator cuff tears using arthroscopically assisted technique of transposition of the latissimus dorsi muscle” No. RU 2791403 C1.

Results. After 6 months of follow-up, all patients were able to return to their daily activities. The average increase on the ASES scale was 49.08, on the DASH scale 52.57, on the SST scale 5.7. All patients noted a decrease in pain syndrome, according to the questionnaires, the average decrease was 4.6. One infectious complication was noted.

Conclusion. The use of the latissimus dorsi tendon transfer is a significant alternative to reverse shoulder arthroplasty with proper selection of patients. This direction requires further research aimed at studying the results, as well as the transition to fully arthroscopic techniques.

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