Combined Pectoralis Major and Latissimus Dorsi Tendon Transfer for Massive Rotator Cuff Deficiency

Author(s): Aldridge JM III, Atkinson TS, Mallon WJ

Source: J Shoulder Elbow Surg 13(6):621-629, 2004

Summary:

his is a retrospective review of 11 consecutive patients treated with combined transfer of the latissimus dorsi and pectoralis major muscles for massive rotator cuff deficiency.  The chief complaint of these patients was diminished shoulder function and motion with little or no accompanying pain.  The study documents the range of motion at 2 years in which the patients were followed. The mean elevation improved from 42° pre-operatively to 86° post-operatively. The mean active external rotation improved from 0 to 13. The mean abduction strength improved from 2.3 to 3.1 and external rotation strength improved from 2.1 to 2.7 according to the Medical Research Council scale. Overall, four patients had no improvement, 2 improved slightly, and 5 improved significantly.  The procedure is well-documented in the paper and involves two incisions. The pectoralis muscle is mobilized anteriorly and the latissimus is mobilized posteriorly.

The results demonstrated that the arc of motion improved substantially in 5 of the 11 patients, whereas 6 effectively made either no or slight improvement. The authors were unable to find any differences between the two groups specifically with regards to age, length of follow up, activity level, or number of previous surgeries. Of the 11 patients, 7 stated they were satisfied with the result and 4 were dissatisfied with the result.  This represents a critical review of 11 patients who underwent a reconstruction for a massive rotator cuff tear in an effort to improve arc of motion. The authors provide valuable insight as to the varied and unpredictable course following this procedure.

 

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