Lower Trapezius Transfer for Irreparable Posterosuperior Rotator Cuff Tears Shows Improved Outcome Despite...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Reconstruction

Background:

• Irreparable posterosuperior rotator cuff tears present significant challenges in shoulder function.
• Lower trapezius transfer is a reconstructive option for these complex injuries.
• The integrity of the subscapularis tendon may influence surgical outcomes.

Purpose of the Study:

• To compare clinical outcomes of lower trapezius transfer in patients with irreparable posterosuperior rotator cuff tears.
• To evaluate the impact of intact versus torn subscapularis tendons on surgical results.

Main Methods:

• Retrospective review of patients undergoing arthroscopic lower trapezius transfer with an Achilles tendon allograft.
• Patients were stratified based on subscapularis tendon integrity (intact vs. torn/repaired).
• Clinical outcomes (pain, function, range of motion) and imaging were assessed at minimum 24-month follow-up.

Main Results:

• All patients demonstrated significant postoperative improvements in pain, function, and range of motion.
• Patients with subscapularis tears had poorer preoperative internal rotation.
• While overall outcomes were similar, patients with repaired Lafosse type II/III tears showed smaller gains in internal rotation compared to the intact group.

Conclusions:

• Lower trapezius transfer yields favorable outcomes for irreparable posterosuperior rotator cuff tears.
• Outcomes are generally comparable between patients with intact and torn subscapularis tendons.
• Subscapularis pathology severity can impact specific functional gains, particularly internal rotation.