ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026
Effect of preoperative subscapularis status on functional recovery after posterior latissimus dorsi tendon transfer for posterior-superior irreparable rotator cuff tears.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePosterior latissimus dorsi (LD) transfer is widely used to treat posterior-superior irreparable rotator cuff tears (PSIRCTs), but the impact of subscapularis integrity on postoperative outcomes remains debated. This study aimed to evaluate the effect of subscapularis integrity on clinical and radiologic outcomes following arthroscopic-assisted posterior LD transfer.
methodsThis retrospective study included patients who underwent arthroscopic-assisted posterior LD transfer for PSIRCTs and were classified into Preoperative Subscapularis Intact and Preoperative Subscapularis Tear groups. Surgical indications included PSIRCTs, intact or repairable subscapularis, and minimal glenohumeral arthritis. Clinical assessments comprised VAS, Constant score, ASES score, and active range of motion (ROM). Radiologic evaluations included acromiohumeral distance (AHD), Hamada grade, and integrity of the transferred tendon. Postoperative complications and the achievement of minimal clinically important differences (MCID) were also recorded.
resultsA total of 53 patients were included, classified into the Preoperative Subscapularis Intact group (n = 34) and the Preoperative Subscapularis Tear group (n = 19). At a mean follow-up of 62.9 ± 12.9 months, both groups demonstrated significant improvements in pain, patient-reported outcome measures (PROMs), and range of motion (ROM). Patients with an intact subscapularis achieved higher postoperative Constant scores (70.7 ± 8.9 vs. 62.3 ± 8.9, p = 0.002) and ASES scores (75.5 ± 8.8 vs. 66.7 ± 8.8, p = 0.001) than those with tears. Retear rates (17.6% vs. 26.3%, p = 0.465) and overall complications were similar between groups. Radiographically, the acromiohumeral distance decreased and the Hamada grade increased slightly in both groups, consistent with previously reported outcomes.
conclusionPosterior LD transfer provides significant improvements in pain, function, and range of motion for patients with PSIRCTs. Although both groups demonstrated meaningful improvements, patients with an intact preoperative subscapularis tended to achieve significantly higher Constant and ASES scores compared with those with preoperative subscapularis tears. LEVEL OF EVIDENCE IV: Retrospective Case-series.
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