Results of Latissimus Dorsi Transfer Associated with the Use of Autologous Fascia Lata Tendon Graft in Irreparable Posterosuperior Rotator Cuff Injuries

背阔肌转移联合自体阔筋膜腱移植治疗不可修复的后上肩袖损伤的疗效

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Abstract

OBJECTIVE: To evaluate the functional outcomes of latissimus dorsi transfer reinforced with an autologous fascia lata graft harvested from the thigh contralateral to the injury to treat irreparable posterosuperior rotator cuff tears (IPSRCTs). The secondary objective was to assess complications related to graft harvesting. METHODS: The present retrospective functional evaluation involved 17 patients (8 men and 9 women), with a mean age of 62.6 (54-73) years and a mean postoperative follow-up period of 21.2 (12-45) months. We compared pre- and postoperative University of California, Los Angeles (UCLA) scores and range of motion (ROM), assessed donor-site hip abduction strength and recorded potential associated complications. The determination of correlations between variables used Pearson's coefficient, with p ≤ 0.05 considered statistically significant. RESULTS: The mean postoperative UCLA score was 27.9 (14-33) points, representing an improvement of 16.7 points compared to the preoperative mean. Range of motion improved significantly ( p  < 0.05), with the following final values: elevation, 27.9°; lateral rotation (LR), 133°; medial rotation (MR) at T9, all with p  < 0.05. No patient presented signs of infection at the graft harvest site; two subjects reported pain in the surgical wound, and one developed a small incisional hernia. CONCLUSION: This technique was effective in treating IPSRCTs, achieving a 70.6% satisfactory outcome based on the UCLA score and showing significant improvement in ROM. The use of an autologous graft represents a viable option with low complication rates, both at the shoulder and hip.

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