Long-term prospective cohort of latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears. It asks whether functional and pain improvements seen at short and intermediate follow-up endure beyond ten years. It also identifies which patient and anatomic factors predict failure.
When you face a younger, high-demand patient with an irreparable posterosuperior cuff tear and want to avoid burning the reverse arthroplasty bridge, latissimus dorsi transfer is a durable option that holds up past ten years.
Patient selection is everything. Before offering this transfer, confirm the subscapularis is competent (negative lift-off and belly-press) and the teres minor is not fatty infiltrated. Both provide the force-couple balance the transfer cannot replace.
This paper introduced the critical shoulder angle as a new predictor. A postoperative CSA ≤36° nearly doubled the chance of an excellent functional result, prompting the authors to recommend shortening the lateral acromion when the angle is large.
Framing matters for boards: this is the pre-reverse-TSA workhorse for joint preservation in the young patient. Reverse arthroplasty is reserved for pseudoparalysis, anterosuperior escape, or irreparable subscapularis loss.
Long-term prospective cohort of latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears. It asks whether functional and pain improvements seen at short and intermediate follow-up endure beyond ten years. It also identifies which patient and anatomic factors predict failure.
When you face a younger, high-demand patient with an irreparable posterosuperior cuff tear and want to avoid burning the reverse arthroplasty bridge, latissimus dorsi transfer is a durable option that holds up past ten years.
Patient selection is everything. Before offering this transfer, confirm the subscapularis is competent (negative lift-off and belly-press) and the teres minor is not fatty infiltrated. Both provide the force-couple balance the transfer cannot replace.
This paper introduced the critical shoulder angle as a new predictor. A postoperative CSA ≤36° nearly doubled the chance of an excellent functional result, prompting the authors to recommend shortening the lateral acromion when the angle is large.
Framing matters for boards: this is the pre-reverse-TSA workhorse for joint preservation in the young patient. Reverse arthroplasty is reserved for pseudoparalysis, anterosuperior escape, or irreparable subscapularis loss.