Does prior rotator cuff surgery affect outcomes of posterior latissimus dorsi tendon transfer for irreparable posterosuperior tears?
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 41994314.
- Also identified by DOI 10.1016/j.jor.2026.02.048 and PMC identifier 13080473.
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Abstract
Posterior latissimus dorsi (LD) tendon transfer is an established surgical option for posterosuperior irreparable rotator cuff tears (PSIRCTs). This study aimed to compare the clinical and radiologic outcomes between primary LD transfer and secondary LD transfer performed after failed rotator cuff repair or other shoulder procedures. This retrospective study included patients undergoing arthroscopically-assisted posterior LD transfer between April 2012 and June 2020 for PSIRCTs without glenohumeral arthritis. Patients with missing data or lost to follow-up were excluded. Subjects were classified as Primary group (no prior surgery) or Secondary group (history of failed rotator cuff repair). Outcomes included VAS, SANE, Constant, ASES score, active range of motion (ROM), muscle strength, acromiohumeral distance (AHD), and tendon integrity on MRI. After excluding 7 patients, 51 were analyzed (Primary, n = 34; Secondary, n = 16). Baseline demographics and preoperative characteristics were similar. Both groups showed significant improvements in all patient-reported outcomes, ROM, and strength (p < 0.001). The Primary group had significantly higher postoperative SANE, Constant, and ASES scores and greater strength in forward elevation, abduction, and external rotation. A higher proportion of patients in the Primary group achieved the minimal clinically important difference (MCID). Re-tear rates were higher in the Secondary group (31.2% vs 10.4%). Posterior LD transfer provides significant improvements in pain relief, function, and shoulder motion in patients with PSIRCTs. Although both groups demonstrated overall improvements in PROM, ROM, and radiologic findings, the re-tear rate was higher in the Secondary group. Furthermore, the Primary group achieved superior postoperative functional scores and greater muscle strength improvement compared with the Secondary group. III: retrospective comparative case series.