• Leonardo Osti, Lorenzo Milani, Emanuele Gerace, Sara Padovani, Leo Massari, and Nicola Maffulli.
• Department of Orthopaedic Surgery, Arthroscopy and Sport Medicine, Hesperia Hospital, Arqua' Street, 41125 Modena, Italy.
• Br. Med. Bull. 2020 Jul 9; 134 (1): 85-96.

IntroductionThe present systematic review compared arthroscopic superior capsular reconstruction (ASCR) and latissimus dorsi transfer (ALDT) for the management of massive irreparable rotator cuff lesions.Sources Of DataWe performed a systematic review searching the literature on Medline, Cochrane and Scopus databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Areas Of AgreementWe included a total of 20 articles, 10 on ASCR and 10 on ALDT (12 retrospective and 8 prospective studies), all published between 2013 and 2019.Areas Of ControversyASCR and ALDT are technical demanding procedures. When compared to each other, they do not produce significantly different improvements in clinical outcome.Growing PointsBoth ASCR and ALDT are valid options for surgical management of MIRCLs. Although ALDT has shown a greater complication rate and a less improvement in acromion-humeral distance, its clinical outcomes overlap those obtained with ASCR.Areas Timely For Developing ResearchFurther comparative prospective and retrospective studies with longer follow-up could confirm which surgical procedure can lead to better outcomes with a lower complication rate.© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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