Irreparable massive rotator cuff tear (IMRCT) is the hotspot and difficulty in sports medicine. Because of the severe retraction, poor quality, serious muscle fat infiltration, and decreased acromiohumeral distance caused by high position in IMRCT, patients usually present with severe dysfunction of upper limb and shoulder joint and remarkable pain. IMRACT usually requires surgery due to the poor outcome of conservative treatment.

To observe the early clinical efficacy of arthroscopic bridge patch of the long head of biceps tendon combined with latissimus dorsi transposition to treat irreparable massive rotator cuff tear and explore the mechanism of this surgical method.

From March 2018 to June 2020, we retrospectively analyzed the clinical data of 15 patients (6 males and 9 females) with IMRCT. Their ages ranged from 56 to 68 years, with an average age of (61.5±3.1) years. The mean preoperative duration of symptoms was (11.7±3.5) months. Preoperative and postoperative shoulder ranges of active motion (upward flexion, lateral external rotation, abduction and external rotation) , shoulder joint radiographs, and MRI were assessed. The visual analog scale (VAS) , University of California Los Angeles (UCLA) score, and Constant-Murley score were used to evaluate shoulder pain and function.

There were no postoperative complications such as retear, bulbous deformity, severe joint adhesion, or infection. All patients were followed up for 7 to 16 months with an average time of (11.5±4.3) months. At preoperative and final follow-ups, the ranges of active motion of the shoulder joint were (85.9±27.4) ° and (149.8±29.7) ° of upward flexion, (21.5±8.9) ° and (38.3±12.4) ° of lateral external rotation, and (52.7±14.2) ° and (73.6±12.8) ° of abduction and external rotation, respectively. The VAS scores were (6.2±1.1 ) scores and (1.4±0.5) scores, respectively. The UCLA scores were (15.4±3.8) scores and (35.1±2.7) scores, respectively. The Constant-Murley scores were (42.8±7.6) scores and (91.2±7.3) scores, respectively. The acromion humeral head distances were (5.2± 1.6) mm and (8.7± 1.3) mm, respectively. The ranges of active shoulder motion, VAS score, UCLA score, and Constant-Murley score were significantly improved than those before surgery (P<0. 001) . At the last follow-up, 6 cases were excellent, 8 cases were good, and 1 was moderate. The excellent and good rate was 93.3% (14/15) .

Arthroscopic bridge patch of the long head of biceps tendon combined with latissimus dorsi transposition in the treatment of irreparable massive rotator cuff tear can significantly relieve pain, restore ranges of motion and improve function.