This is a retrospective case series of 17 patients who underwent latissimus dorsi transfer as a salvage procedure after a failed repair of a massive rotator cuff tear. All had persistent pain and lost motion with no local tissue left to re-repair. It asks whether transferring the latissimus dorsi can relieve pain and restore function in these difficult, worst-case shoulders.
When a massive cuff tear has already failed one repair and no local tissue remains, re-repair is a poor bet. A second open repair fails in more than half of patients (14 of 24, 58% in DeOrio and Cofield).
Latissimus dorsi transfer offers a salvage path that relieved pain in 14 of 17 shoulders here. Frame the goal correctly for the patient: this reliably reduces pain and gives usable elevation, but it does not restore a normal shoulder — the average UCLA score reached only 16.4, which is fair.
Two teaching points cut against older dogma. A detached anterior deltoid or an absent subscapularis, once seen as barriers, did not prevent good outcomes here, so neither is an absolute contraindication.
The strongest negative predictor was social, not anatomic: every failure was a Workers' Compensation patient. When counseling a work-injured patient, set expectations low and do not promise return to work.
This is a retrospective case series of 17 patients who underwent latissimus dorsi transfer as a salvage procedure after a failed repair of a massive rotator cuff tear. All had persistent pain and lost motion with no local tissue left to re-repair. It asks whether transferring the latissimus dorsi can relieve pain and restore function in these difficult, worst-case shoulders.
When a massive cuff tear has already failed one repair and no local tissue remains, re-repair is a poor bet. A second open repair fails in more than half of patients (14 of 24, 58% in DeOrio and Cofield).
Latissimus dorsi transfer offers a salvage path that relieved pain in 14 of 17 shoulders here. Frame the goal correctly for the patient: this reliably reduces pain and gives usable elevation, but it does not restore a normal shoulder — the average UCLA score reached only 16.4, which is fair.
Two teaching points cut against older dogma. A detached anterior deltoid or an absent subscapularis, once seen as barriers, did not prevent good outcomes here, so neither is an absolute contraindication.
The strongest negative predictor was social, not anatomic: every failure was a Workers' Compensation patient. When counseling a work-injured patient, set expectations low and do not promise return to work.