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Author Reply to “Regarding ‘High Clinical Failure Following Latissimus Dorsi Transfer for Revision Massive Rotator Cuff Tears’”

      We are writing in response to the letter from Dr. Neviaser, for whom we have great respect. We appreciate his letter, and he makes excellent points regarding the latissimus dorsi transfer as a salvage procedure. His previous study described 17 patients with previously failed rotator cuff repairs who showed increased range of motion and overall satisfaction with a latissimus dorsi transfer.
      • Birmingham P.M.
      • Neviaser R.J.
      Outcome of latissimus dorsi transfer as a salvage procedure for failed rotator cuff repair with loss of elevation.
      He also mentions in his letter that their mean ASES was 61/100 postoperatively.
      Setting patient expectations are important, and a final score of 61/100 in a relatively young person is not ideal, in our opinion. In addition, part of the reason we wrote our initial article
      • Muench L.N.
      • Kia C.
      • Williams
      • et al.
      High clinical failure rate after latissimus dorsi transfer for revision massive rotator cuff tears.
      was to open the conversation for other potential options, such as a lower trapezius transfer or even a biologic graft augmentation. As mentioned in the editorial commentary,
      • Li X.
      Editorial commentary: Is it time to abandon the latissimus dorsi tendon transfer as a salvage procedure for patients with large irreparable rotator cuff tears that failed primary repair?.
      we wanted to show that despite exhausting various efforts, at least in our hands, the latissimus dorsi transfer did not give us the results we wanted for this young population.
      Dr. Neviaser is completely right, and we agree that you should not overlook the latissimus dorsi transfer, but take into account the variability and success it can provide patients for such an involved surgery.

      Supplementary Data

      References

        • Birmingham P.M.
        • Neviaser R.J.
        Outcome of latissimus dorsi transfer as a salvage procedure for failed rotator cuff repair with loss of elevation.
        J Shoulder Elbow Surg. 2008; 17: 871-874
        • Muench L.N.
        • Kia C.
        • Williams
        • et al.
        High clinical failure rate after latissimus dorsi transfer for revision massive rotator cuff tears.
        Arthroscopy. 2020; 36: 88-94
        • Li X.
        Editorial commentary: Is it time to abandon the latissimus dorsi tendon transfer as a salvage procedure for patients with large irreparable rotator cuff tears that failed primary repair?.
        Arthroscopy. 2020; 36: 95-98

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