Muscle Tendon Transfers for Massive Rotator Cuff Tears: Midterm follow-up

Several types of muscle tendon transfers have been described in literature as a
salvage procedure for irreparable posterior-superior massive RC tears, two of
these treatment options have been adopted in our hospital: the m. teres major
(TM) transfer and m. latissimus dorsi (LD) transfer. Which tendon transfer
results in the best functional outcome remains controversial. One or the other
might have better functional improvements of might have potential
disadvantages. In an analysis of muscle function, the TM transfer proved to be
successful. Yet no long-term clinical outcome results have been reported for
the TM transfer. Midterm outcome of LD transfer are relatively favourable,
however reported for variable indications in small research groups.
In this project we will evaluate the potential (dis)advantages of the two
transfers at midterm follow-up.
Our first hypothesis is that at follow-up, the Range of Motion (RoM) will be
increased in both patient groups versus the pre-operative status. Our second
hypothesis is that the TM transfer group and LD group will show significant
improvement in active abduction and external rotation; this will lead to
significant increase in quality of life.

The study is primarily designed to discribe the clinical outcome at mid-term
follow-up in respect to the baseline of the TM transfer and the LD transfer in
patients with a massive posterior-superior rotator cuff tear. Our secondary
objective is to asses the quality of life in these patients, which received
either a TM transfer or a LD transfer.

Retrospective cohort study with two historical patient groups: one group
received a TM transfer (2003-2007) and the other group received a LD transfer
(2007-2009).

The potential risk associated with this study is negligible. While the subjects
participating in this study may not directly derive any immediate benefits, the
results of this study should improve the understanding of which muscle in which
patients* type is best to transfer. This information will be extremely useful
in optimizing treatment of irreparable massive RC tears, and improving
long-term results. Further treatment and rehabilitation strategies might be
adapted and optimized based on the findings of this study.
The questionnaires and measurements at the outpatient clinic will cost extra
time for the patient. This includes patient history, RoM, CS and 3 self report
questionnaires (SF-12, DASH and WORC). No physiological discomfort during test
administration is to be expected.