Mid- to long-term outcomes of latissimus dorsi tendon transfer for massive irreparable posterosuperior rotator cuff tears: a systematic review and meta-analysis

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dc.coverageDOI: 10.1016/j.jse.2023.10.002
dc.creatorVelasquez Garcia, Ausberto
dc.creatorNieboer, Micah J.
dc.creatorde Marinis, Rodrigo
dc.creatorMorrey, Mark E.
dc.creatorValenti, Philippe
dc.creatorSanchez-Sotelo, Joaquin
dc.date2024
dc.date.accessioned2025-11-18T19:45:57Z
dc.date.available2025-11-18T19:45:57Z
dc.description<p>Background: This study aims to analyze the mid-to long-term results of the latissimus dorsi tendon for the treatment of massive posterosuperior irreparable rotator cuff tears as reported in high-quality publications and to determine its efficacy and safety. Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Scopus, and EMBASE databases were searched until December 2022 to identify studies with a minimum 4 year follow-up. Clinical and radiographic outcomes, complications, and revision surgery data were collected. The publications included were analyzed quantitatively using the DerSimonian Laird random-effects model to estimate the change in outcomes from the preoperative to the postoperative condition. The proportion of complications and revisions were pooled using the Freeman-Tukey double arcsine transformation. Results: Of the 618 publications identified through database search, 11 articles were considered eligible. A total of 421 patients (432 shoulders) were included in this analysis. Their mean age was 59.5 ± 4 years. Of these, 277 patients had mid-term follow-up (4-9 years), and 144 had long-term follow-up (more than 9 years). Postoperative improvements were considered significant for the following outcome parameters: Constant-Murley Score (0-100 scale), with a mean difference (MD) = 28 points (95% confidence interval [CI] 21, 36; I<sup>2</sup> = 89%; P &lt; .001); visual analog scale, with a standardized MD = 2.5 (95% CI 1.7, 3.3; P &lt; .001; I<sup>2</sup> = 89%; P &lt; .001); forward flexion, with a MD = 43° (95% CI 21°, 65°; I<sup>2</sup> = 95% P &lt; .001); abduction, with a MD = 38° (95% CI 20°, 56°; I<sup>2</sup> = 85%; P &lt; .01), and external rotation, with a MD = 8° (95% CI 1°, 16°; I<sup>2</sup> = 87%; P = .005). The overall reported mean complication rate was 13% (95% CI 9%, 19%; I<sup>2</sup> = 0%), while the reported mean revision rate was 6% (95% CI: 3%, 9%; I<sup>2</sup> = 0%). Conclusions: Our pooled estimated results seem to indicate that latissimus dorsi tendon transfer significantly improves patient-reported outcomes, pain relief, range of motion, and strength, with modest rates of complications and revision surgery at mid-to long-term follow-up. In well-selected patients, latissimus dorsi tendon transfer may provide favorable outcomes for irreparable posterosuperior cuff tears.</p>eng
dc.identifierhttps://investigadores.uandes.cl/en/publications/a9c22fdb-d167-47b9-a1f1-04f381901233
dc.identifier.urihttps://repositorio.uandes.cl/handle/uandes/54248
dc.languageeng
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.sourcevol.33 (2024) nr.4 p.959-974
dc.subjectIRCT
dc.subjectirreparable posterosuperior rotator cuff tear
dc.subjectLatissimus dorsi tendon transfer
dc.subjectLDTT
dc.subjectLevel IV
dc.subjectpatient-reported outcomes
dc.subjectrange of motion
dc.subjectSystematic Review and Meta-Analysis
dc.subjecttendon transfer
dc.titleMid- to long-term outcomes of latissimus dorsi tendon transfer for massive irreparable posterosuperior rotator cuff tears: a systematic review and meta-analysiseng
dc.typeReview articleeng
dc.typeArtículo de revisiónspa
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