Single versus dual tendon transfer for global irreparable rotator cuff tears

This retrospective study compared the outcomes between single (anterior latissimus dorsi and teres major [aLDTM] tendon transfer) versus dual (aLDTM tendon transfer with arthroscopy-assisted lower trapezius tendon transfer) tendon transfer for global irreparable rotator cuff tears (GIRCTs).

48 patients of the single transfer group and 25 patients of the dual transfer group were included. Primary outcome was the activities of daily living requiring external rotation (ADLER) score. Secondary outcomes were the visual analog scale (VAS) score, other patient-reported outcome measurements (PROMs), active range of motion (aROM), reversal rate of pseudoparalysis and external rotation (ER) lag sign, and muscle strength.

Both groups showed significant improvements in VAS score, PROMs, aROM, and muscle strength. However, the primary outcome (ADLER), aROM of ER, FE strength, and ER strength of the dual transfer group were significantly higher than that of the single transfer group. While all cases of pseudoparalysis and ER lag sign improved postoperatively in the dual transfer group, this was not the case in the single transfer group.

Although both single and dual tendon transfers are effective treatment options for GIRCTs, dual transfer may be more appropriate when a patient presents with pseudoparalysis or ER lag sign preoperatively.

Level III, retrospective comparative study.