CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(05): 671-674
DOI: 10.1055/s-0041-1726060
Nota Técnica
Ombro e Cotovelo

Latissimus Dorsi Transfer to Irreparable Anterosuperior Lesions to the Rotator Cuff: Description of Surgical Technique[*]

Article in several languages: português | English
1   Grupo de Cirurgia do Ombro, Departamento de Ortopedia e Traumatologia, Santa Casa de Porto Alegre, Porto Alegre, RJ, Brasil
,
1   Grupo de Cirurgia do Ombro, Departamento de Ortopedia e Traumatologia, Santa Casa de Porto Alegre, Porto Alegre, RJ, Brasil
,
1   Grupo de Cirurgia do Ombro, Departamento de Ortopedia e Traumatologia, Santa Casa de Porto Alegre, Porto Alegre, RJ, Brasil
,
1   Grupo de Cirurgia do Ombro, Departamento de Ortopedia e Traumatologia, Santa Casa de Porto Alegre, Porto Alegre, RJ, Brasil
,
2   Departamento de Ortopedia e Traumatologia, Clínica Conex, Ijuí, RS, Brasil
,
1   Grupo de Cirurgia do Ombro, Departamento de Ortopedia e Traumatologia, Santa Casa de Porto Alegre, Porto Alegre, RJ, Brasil
› Author Affiliations

Abstract

Lesions to the shoulder rotator cuff may have several configurations, and are divided and classified according to the size of the lesion, the tendon involved, its combinations and whether there is possibility of repair. Irreparable subscapular lesions, as well as irreparable anterosuperior lesions, may generate shoulder dysfunction due to loss of humeral head depressants, causing pain and functional limitation. Myotendinous transfers are among the therapeutic alternatives, and the most studied and widespread in recent decades is the transfer of the pectoralis major to the minor tuberosity. However, some anatomical studies suggest that the latissimus dorsi is a more appropriate alternative for the treatment of these lesions because it presents force vectors more similar to those of the subscapularis, besides presenting promising results in the clinical evaluations with short follow-up. The present work aims to describe the surgical technique developed for transfer of the latissimus dorsi in cases of irreparable subscapular and anterossuperior lesions to the rotator cuff.

* Work developed at the Shoulder Surgery Group, Department of Orthopedics and Traumatology, Santa Casa de Porto Alegre, Porto Alegre, RJ, Brazil.




Publication History

Received: 30 July 2020

Accepted: 28 October 2020

Article published online:
28 October 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • Referências

  • 1 Resch H, Povacz P, Ritter E, Matschi W. Transfer of the pectoralis major muscle for the treatment of irreparable rupture of the subscapularis tendon. J Bone Joint Surg Am 2000; 82 (03) 372-382
  • 2 Omid R, Lee B. Tendon transfers for irreparable rotator cuff tears. J Am Acad Orthop Surg 2013; 21 (08) 492-501
  • 3 Kany J, Guinand R, Croutzet P, Valenti P, Werthel JD, Grimberg J. Arthroscopic-assisted latissimus dorsi transfer for subscapularis deficiency. Eur J Orthop Surg Traumatol 2016; 26 (03) 329-334
  • 4 Greenspoon JA, Petri M, Warth RJ, Millett PJ. Massive rotator cuff tears: pathomechanics, current treatment options, and clinical outcomes. J Shoulder Elbow Surg 2015; 24 (09) 1493-1505
  • 5 Konrad GG, Sudkamp NP, Kreuz PC, Jolly JT, McMahon PJ, Debski RE. Pectoralis major tendon transfers above or underneath the conjoint tendon in subscapularis-deficient shoulders. An in vitro biomechanical analysis. J Bone Joint Surg Am 2007; 89 (11) 2477-2484
  • 6 Moroder P, Schulz E, Mitterer M, Plachel F, Resch H, Lederer S. Long-Term Outcome After Pectoralis Major Transfer for Irreparable Anterosuperior Rotator Cuff Tears. J Bone Joint Surg Am 2017; 99 (03) 239-245
  • 7 Elhassan B, Ozbaydar M, Massimini D, Diller D, Higgins L, Warner JJ. Transfer of pectoralis major for the treatment of irreparable tears of subscapularis: does it work?. J Bone Joint Surg Br 2008; 90 (08) 1059-1065
  • 8 Elhassan B, Christensen TJ, Wagner ER. Feasibility of latissimus and teres major transfer to reconstruct irreparable subscapularis tendon tear: an anatomic study. J Shoulder Elbow Surg 2014; 23 (04) 492-499