Does adding arthroscopic partial repair of the supraspinatus improve outcomes in combined anterior latissimus dorsi and teres major tendon transfer for irreparable anterosuperior rotator cuff tears?

Abstract

Background

Combined anterior latissimus dorsi and teres major (aLDTM) tendon transfer is an effective treatment for anterosuperior irreparable rotator cuff tears (ASIRCTs). Adding partial rotator cuff repair (pRCR) of the supraspinatus may enhance outcomes.

Methods

This retrospective study compared combined aLDTM with pRCR (Group P, 19 patients) versus aLDTM alone (Group A, 40 patients) for ASIRCTs treated between January 2020 and June 2022. Outcomes included visual analog scale (VAS) score, patient-reported outcome measures (PROMs), active range of motion (aROM), aROM strength, acromiohumeral distance (AHD), and Hamada grade.

Results

Both groups showed significant VAS and PROM improvements. PROMs were significantly higher in Group P at 3, 6, and 12 months, but not at final follow-up. aROM, strength, AHD, and Hamada grade did not differ significantly between groups. Partial tears of the transferred LDTM occurred in one patient (5.3%) in Group P and three patients (7.5%) in Group A. Retears of the prepared rotator cuff occurred in 10 patients (52.6%) in Group P.

Conclusion

Although adding pRCR to combined aLDTM tendon transfer may not yield additional long-term benefits, it may be considered in selected patients with ASIRCTs to facilitate early clinical recovery and enhance early postoperative outcomes.

Level of evidence: Level III.