Letter regarding article by Clavert et al.: long-term outcomes of latissimus dorsi transfer for irreparable rotator cuff tears

Excerpt

We read the article entitled “Long-term outcomes of latissimus dorsi transfer for irreparable rotator cuff tears” (published online March 28, 2020) with great interest [1]. The management of large irreparable rotator cuff tears in the young and active patient population without osteoarthritis presents a challenge for shoulder surgeons due to the limited number of treatment options available that provide predictable outcomes [2]. The study by Clavert et al. addressed the controversy that stands regarding the role of latissimus dorsi (LD) after muscle transfer for irreparable rotator cuff tears. There are conflicting data whether a favourable clinical outcome after this surgery is due to the LD muscle contraction rather than the passive tenodesis. Indeed, the ability of the transfer to modify the activity of the LD muscle from being an internal rotator to an external rotator of the shoulder is still to be definitively confirmed, and a review of the literature on this issue identified four articles published in PubMed database in the last four months [1‐4]. This is a relevant question because of the steep learning curve an orthopaedic surgeon has to deal with to perform this technique without compromising patient safety [5]. …