Peter J. Millet, M.D., Jonas Pogorzelski, Marilee P. Horan, Jonathan A. Godin, Zaamin B. Hussain, and Erik M. Fritz
The purpose of this study was to investigate clinical outcomes following Achilles tendon allograft-augmented latissimus dorsi tendon transfer (LDTT) for the treatment of irreparable posterosuperior rotator cuff tears with a minimum of 2 years post-operative follow-up. We hypothesized that patients would show significant improvement in outcomes scores with a low failure rate.
Materials and methods
Patients who were treated with Achilles tendon allograft-augmented LDTT for irreparable postero-superior rotator cuff tears with a minimum follow-up of 2 years were included. Patient-reported outcomes scores, including ASES, QuickDASH, SANE, SF-12 PCS, and satisfaction, were collected pre- and post-operatively. Pre- and post-operative scores were compared with a Wilcoxon test. Revision to reverse total shoulder arthroplasty (RTSA) was considered as failure.
Between March 2006 and November 2014, a total of 16 patients with a mean age of 49 years (range 34–57 years) were included. Minimum 2-year outcomes data were available for 14 of the 16 patients (87.5%) with a mean follow-up of 5.5 years (range 2.1–10.5 years). Two patients (12.5%) advanced to RTSA at a mean of 1.1 years following LDTT. Post-operative median subjective outcomes scores improved, but did not reach statistical significance (SF-12 PCS: 35.4–46.4, P = 0.182; ASES: 47.5–69.9, P = 0.209; QuickDASH: 57.9–31.8, P = 0.176; SANE: 40.0–39.5, P = 0.273). Median post-operative patient satisfaction was 5 on a 10-point scale (range 1–10).
Patients with irreparable rotator cuff tears treated with Achilles tendon allograft-augmented latissimus dorsi tendon transfer did not experience significant post-operative improvement in patient-reported outcomes. Thus, the use of an additional allograft-augmentation remains questionable.
For the complete study: Achilles tendon allograft-augmented latissimus dorsi tendon transfer for the treatment of massive irreparable posterosuperior rotator cuff tears