Open Access
Review
Table 1
Latissimus dorsi tendon transfer techniques.
| Method | Aim | Surgical procedure | Advantages | Disadvantages |
|---|---|---|---|---|
| L’Episcopo [17] | To correct existing disability and restore muscle balance. | The contracted anterior tissues are released using Sever’s technique. Teres major and latissimus dorsi (LD) tendons are transferred to act as external rotators. | This technique does not only correct the deformity but also addresses the problem of muscle imbalance. | This is a salvage method. |
| Gerber et al. [13] | To close massive rotator cuff defect and exert an external rotation as well as act as a humeral head depressor. | Double incisions are performed. Harvesting the LD tendon with an axillary approach and transfer to treat the rotator cuff defects. | Symptomatic patients with irreparable cuff tears can be treated. | Neurological complications, deltoid avulsion, double incision |
| Habermeyer et al. [36] | To treat irreparable rotator cuff tears | A single incision is performed in the axillary pouch. LD tendon is detached from its insertion. The greater tuberosity is identified and LD tendon is transferred. | Single-incision | |
| Less neurovascular complication | ||||
| Gerber et al. [60] | Combination of reverse shoulder arthroplasty with LD tendon transfer | LD tendon is harvested by axillary incision and joint replacement is made with deltopectoral or superolateral approach. | Restoration of both external rotation and elevation deficits | Double incision, longer surgery |
| Gervasi et al. [41] | Arthroscopic latissimus dorsi transfer for irreparable massive rotator cuff tears | The shoulder joint is first visualized arthroscopically. The prepared LD tendon is reattached at the footprint of supraspinatus tendon. | Arthroscopic assistance while reattaching tendon | Endoscopic graft harvesting is time-consuming and no benefits. |
| Less wound complication | ||||
| Avoiding deltoid harm | ||||
| Boileau et al. [38] | To treat irreparable rotator cuff tears as a part of reverse shoulder arthroplasty procedure. | An extended deltopectoral approach is used. LD and teres major tendons insertions are detached from the humeral periosteum. Two tendons are fixed directly to the pectoralis major stump. | Single-incision | Longer surgery |
| Less neurovascular complication | ||||
| Elhassan et al. [54] | To address massive and irreparable subscapularis tendon tears | A standard deltopectoral approach is performed. LD tendon with bony attachment is harvested and transferred to the humeral head. | More satisfactory outcomes that pectoralis major/minor transfer | |
| No nerve entrapment | ||||
| Better anatomically and biomechanically |
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