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Clinical outcomes in latissimus dorsi transfer single- versus double-incision technique

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background/hypothesis

In patients with irreparable postero-superior rotator cuff lesions, a latissimus dorsi transfer (LDT) is performed. For this surgery, different techniques are used.

In this study, we aim to compare the patient’s functional outcome after treatment with modified L’Episcopo “single-incision” and modified Gerber “double-incision” technique for LDT.

Methods

44 patients with irreparable postero-superior rotator cuff ruptures, refractory to physiotherapeutic treatment were included. 21 patients were treated using a modified L’Episcopo “single-incision”, 23 patients with modified Gerber “double-incision” surgical approach. All patients had full-thickness tears of at least two complete tendons, and all had fully functioning deltoid and subscapularis muscles. Preoperatively, there were statistically significant differences between the two groups in all preoperative CMS sub-parameters except “power” and “pain”. In the postoperative follow-up, a functional assessment using “Constant–Murley Score” (CMS) and “Age- and gender-related CMS” was conducted.

Study design

Retrospective-comparative trial. Level of evidence III.

Results

There were no statistically significant differences between age, sex and time of follow-up between the two study groups (p > 0.05). The mean age was 59.2(± 6.3) years, and the mean follow-up time was 45.4(± 9.3) months for both groups taken together.

Mean CMS improved for both groups together from 24.2 ± 8.2 points prior to surgery, to 62.8 ± 17.4 points after a mean follow-up time of 45.4 ± 9.3 months post surgery. The patients treated with “single-incision” surgery (n = 21) gained significantly (p < 0.001) more in CMS and all CMS-sub-scoring parameters except power and pain, compared to the patients treated with “double-incision” technique (n = 23).

Conclusion

This survey shows appealing post-operative functional outcome in patients with irreparable postero-superior rotator cuff lesions treated with two different techniques for LDT. We believe that the presentation of these methods and their results might encourage shoulder surgeons to implement these techniques. Especially the “single-incision” LDT surgery might be a more accustomed technique for many shoulder surgeons well trained in the deltopectoral approach.

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Authors and Affiliations

  1. Department of Traumatology and Orthopedics, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    Hans-Christian Jeske, Markus Wambacher & Michael Liebensteiner

  2. ATOS Clinic, Effnerstraße 38, 81925, Munich, Germany

    Mark Tauber

  3. Department of Traumatology and Orthopedics, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria

    Mark Tauber

  4. Orthoplus, Talfergasse 2, 39100, Bolzano, Italy

    Hans-Christian Jeske & Florian Perwanger

  5. Department of Traumatology, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria

    Franz Kralinger

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  1. Hans-Christian Jeske
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  2. Mark Tauber
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Correspondence to Hans-Christian Jeske.

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Jeske, HC., Tauber, M., Wambacher, M. et al. Clinical outcomes in latissimus dorsi transfer single- versus double-incision technique. Arch Orthop Trauma Surg 143, 1741–1751 (2023). https://doi.org/10.1007/s00402-021-04291-3

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