Deltoid flap reconstruction for massive rotator cuff tears: mid- and long-term functional and structural results

Abstract

Background: Various open and arthroscopic techniques for irreparable massive rotator cuff tears have been described. Muscle-tendon transfers may be considered in order to improve range of motion and strength.

Materials and methods: We assessed retrospectively the functional and structural results of 31 deltoid flap transfers for massive postero-superior rotator cuff tears at 2 time points: Mid- and long-term follow-up exams were performed after a mean of 53 and 175 months, respectively.

Results: Functional gains were minor, but improvement in pain and patient satisfaction was high. The mean Constant score improved from 31 preoperatively to 46 points at mid-term follow-up. At long-term follow-up, 16 shoulders were still available for exam and presented with a mean Constant score of 66 points. Survival rates of the deltoid flap, confirmed by ultrasound, were 16.5% at mid-term and 12.5% at long-term follow-up, and correlated with better clinical outcome. Cranial migration of the humeral head progressed in all cases and could not be prevented by the interposition of a deltoid flap.

Conclusion: Based on the results of this series, we no longer use nor recommend this technique.