Latissimus Dorsi, Rotator Cuff Tear, Repairing a Rotator Cuff Tear

Latissimus Dorsi Transfer – Tendon Transfer to Repair Rotator Cuff

What Is a Latissimus Dorsi Transfer?

Latissimus dorsi refers to one of the largest muscles in your back. You may have heard it being referred to as your ‘lats’. Your latissimus dorsi, or lats, control the movement of your shoulders. 

The latissimus dorsi transfer is a treatment option for massive or irreparable rotator cuff tears. It involves the “re-routing” of the latissimus dorsi to take over the function of the torn rotator cuff. 


Why Would Someone Need a Latissimus Dorsi Transfer?

Rotator cuff tears result from either injury or as a result of degeneration due to overuse or age. They cause pain and loss of shoulder motion, which thus reduces the quality of lives of patients. If picked up early, these can be repaired with arthroscopic, minimally invasive techniques. 

Despite advances in technology and techniques, there remains a group of patients whose tears cannot be repaired. The following reasons contribute to tears that cannot be repaired:

  1. Large tears which have retracted and cannot be reattached
  2. Tears involving two or more muscles of the rotator cuff
  3. Tears that have been left untreated for too long. This length of time varies from individuals to individuals and may be as short as a few months 
  4. Older patients whose tendons may have degenerated beyond repair

Irreparability does not mean living with life-long pain and disability in the right hands. Hence irreparability does not mean untreatable. 


How Does a Latissimus Dorsi Transfer Repair a Rotator Cuff Tear?

A latissimus dorsi transfer is a specialised operation performed under general anaesthesia. The latissimus dorsi muscle is first detached from its insertion on the humerus through a small incision in the armpit. 

The muscle is then mobilised to ensure it can reach the new insertion site at the rotator cuff. The tendon of the muscle is then prepared. Finally, the tendon is attached at the rotator cuff insertion arthroscopically using minimally invasive techniques. 


Postoperative Management After Undergoing a Latissimus Dorsi Transfer?

Immediately following surgery, patients are placed in a sling for comfort and to reduce the pain. Additionally, painkillers will be prescribed. With modern multimodal analgesia, pain can be reduced to a tolerable level, and most patients may be discharged from the hospital after a night’s stay. 

Patients are allowed to use their hands for simple activities of daily living to reduce the inconvenience following surgery. Shoulder blade movements may commence immediately after surgery. At two weeks, stitches will be removed, and physiotherapy will begin. 

The rehabilitative physiotherapy process is similar to that for rotator cuff repairs. Additionally, the length of time needed to restore function is similar or may even be shorter.