Editorial Commentary: Isolated Arthroscopic-Assisted Posterior Latissimus Dorsi Transfer May Not Be Sufficient Treatment for Posterosuperior Irreparable Rotator Cuff Tears.

Abstract

Posterosuperior irreparable rotator cuff tears (PSIRCTs) are challenging to treat with both conservative and surgical approaches. Patients with PSIRCTs often have a high burden of suffering with regard to pain level and functional impairments. Different surgical treatment options are available for PSIRCTs depending on age, functional requirements, and grade of osteoarthritis: joint-preserving procedures such as arthroscopic debridement, partial repair with or without augmentation, superior capsular reconstruction, and subacromial balloon spacer for young and active patients and joint-replacing surgery, such as reverse shoulder arthroplasty, in elderly patients with osteoarthritis. Tendon transfer surgeries are also a reliable treatment method for patients with PSIRCTs and without osteoarthritis. Various tendon transfer techniques are known. The traditional latissimus dorsi transfer or the combination of latissimus dorsi and teres major transfer is frequently performed in patients with PSIRCTs. More recent transfer techniques make use of the lower trapezius tendon with promising clinical results. Apart from pain reduction, another important aim of all tendon transfer methods is the functional improvement, especially for activities of daily living, such as eating, drinking, or combing the hair, by reinforcing the forward elevation and external rotation.