Lower Trapezius Tendon Transfer for Massive Irreparable Rotator Cuff Tears

Stoll, Laura E.; Codding, Jason L.

doi:10.1016/j.ocl.2019.03.004

Cited by 24 publications

(14 citation statements)

References 37 publications

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“…Historically, the latissimus dorsi (LD) in addition to the lesser used teres major transfer were used for irreparable posterior-superior cuff tears 24 . Yet, the direction of pull of the LT is in-line and in-phase with the infraspinatus, leading to easier rehabilitation and recruitment 25,26 . To date, there have been no studies comparing LT with LD transfer, but cadaveric studies have shown LT provides a superior external rotation moment arm compared to LD or teres major transfers 25,26 .…”

Section: Discussionmentioning

confidence: 99%

Superior Capsule Reconstruction and Lower Trapezius Transfer for Irreparable Posterior-Superior Rotator Cuff Tear

McCormick

Menendez

Hodakowski³

et al. 2022

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Case:A 49-year-old right-hand-dominant male weightlifter was referred with persistent left shoulder pain, weakness, and range of motion limitations after failed arthroscopic rotator cuff repair and subsequent arthroscopic debridement for a massive posterior-superior supraspinatus and infraspinatus tear. The patient underwent a superior capsular reconstruction (SCR) with lower trapezius (LT) transfer to re-establish rotator cuff function.Conclusion:LT transfer in addition to SCR may be a promising modality to treat massive, irreparable posterior-superior rotator cuff tears in young adults. LT transfer can optimize external rotation, whereas SCR may more adequately address pain and forward elevation.

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Section: Discussionmentioning

confidence: 99%

Superior Capsule Reconstruction and Lower Trapezius Transfer for Irreparable Posterior-Superior Rotator Cuff Tear

McCormick

Menendez

Hodakowski³

et al. 2022

JBJS Case Connector

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“…It is supplied by the transverse cervical artery and innervated by the spinal accessory nerve. 21 LT transfer is thought to provide a better anterior-posterior balancing force than LD. Unlike the LD tendon, which provides an internal rotation vector, the LT has a line of pull that is in the same direction as the infraspinatus, more closely resembling the posterosuperior musculature, making it biomechanically a better option.…”

Section: Anatomical Considerationsmentioning

confidence: 99%

Tendon transfers for irreparable rotator cuff tears

Adam

Nanjayan

Johnson

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Symptomatic irreparable rotator cuff tears pose a challenge for shoulder surgeons. Whilst reverse polarity shoulder arthroplasty is an effective option for older symptomatic patients who have exhausted conservative management, the optimal treatment for younger patients remains controversial. In this article we outline the main tendon transfer options, including anatomical considerations, indications, contraindications, surgical technique, complications and a review of the evidence. Tendon transfers provide an alternative joint-preserving surgical option, but the evidence so far is limited, with a clear need for well-designed comparative studies to confirm their effectiveness.

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“…j Advanced age. j Deltoid deficiency [22]. When there is a preoperative non-functioning deltoid after aaLLT, the patient may recover their ER but they will not improve ABD or elevation [23].…”

Section: Disadvantagesmentioning

confidence: 99%

Lower trapezius transfer for massive posterosuperior rotator cuff defects

Rodríguez-Vaquero¹,

López-Fernández

Calvo

2021

Oper Orthop Traumatol

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Objective: To present the arthroscopically assisted lower trapezius transfer technique that restores shoulder external rotation and forward elevation, with low complication rates and fast recovery. Indications: Massive irreparable posterosuperior rotator cuff tears in active young patients with fatty infiltration ≥ III, osteoarthrosis Hamada ≤ 3, normal function of lower trapezius, and without glenohumeral stiffness. Contraindications: Absolute: Active soft tissue infection and trapezius muscle paralysis. Relative: medical comorbidities, inability to follow postoperative recommendations, advanced age, advanced degenerative changes (Hamada > 3), deltoid deficiency, and forward elevation < 60º. Surgical technique: Beach chair position. Lower trapezius harvesting, allograft preparation, arthroscopic evaluation and rotator cuff partial repair, allograft passage, allograft intraarticular arthroscopic attachment, lower trapezius-allograft open attachment and wound closure.Postoperative management: Avoidance of internal rotation with an external rotation brace for 6 weeks. At 6 weeks progressively appropriate physical therapy. Unrestricted activity at 6 months. Results: At mean follow-up of 14 months, good results were reported (pain, range of motion, and Subjective Shoulder Value and Disabilities of the Arm and Shoulder and Hand scores). Long-term symptoms, Hamada 3 rotator cuff arthropathy, and true pseudo paralysis were associated with negative clinical outcomes, but subscapularis pathology and teres minor fatty atrophy were not. A low complication rate was described. Arthroscopically assisted lower trapezius transfer may restore motion and strength in external rotation. Good results with low complication rates have been reported. It has become the authors' procedure of choice in young active patients with irreparable massive rotator cuff tears. KeywordsIrreparable rotator cuff tears • Massive rotator cuff tear • Arthroscopic lower trapezius transfer • Shoulder tendon transfer • Shoulder reconstruction • Lower trapezius

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Lower Trapezius Tendon Transfer for Massive Irreparable Rotator Cuff Tears

Cited by 24 publications

References 37 publications

Superior Capsule Reconstruction and Lower Trapezius Transfer for Irreparable Posterior-Superior Rotator Cuff Tear

Superior Capsule Reconstruction and Lower Trapezius Transfer for Irreparable Posterior-Superior Rotator Cuff Tear

Tendon transfers for irreparable rotator cuff tears

Lower trapezius transfer for massive posterosuperior rotator cuff defects

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