Related Experiment Video
Updated: May 23, 2026
10:10
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Lower Trapezius Transfer at the Time of Reverse Shoulder Arthroplasty with an Allograft-Prosthetic Composite Can
Joaquin Sanchez-Sotelo1, Christopher M Hart1, Tristan B Weir1
1Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.
Summary
This study combined reverse shoulder arthroplasty (RSA) with an allograft-prosthetic composite (APC) and lower trapezius transfer (LTT). This innovative technique shows promise for restoring active external rotation in shoulders with significant bone loss and cuff deficiency.
Area of Science:
- Orthopedic Surgery
- Shoulder Reconstruction
- Biomaterials in Arthroplasty
Background:
- Proximal humeral bone loss and posterosuperior rotator cuff deficiency present significant challenges in shoulder arthroplasty.
- Traditional reverse shoulder arthroplasty (RSA) may not adequately address these complex pathologies.
Purpose of the Study:
- To describe and report outcomes of a novel surgical technique combining RSA with an allograft-prosthetic composite (APC) and a lower trapezius transfer (LTT).
- To evaluate the potential of this combined approach to restore shoulder function, particularly active external rotation.
Main Methods:
- Twenty-seven patients underwent RSA with an APC and LTT between 2019 and 2023.
- The LTT involved transferring the lower trapezius tendon to the infraspinatus of the allograft.
- Follow-up was conducted for a minimum of 2 years on 26 patients.
Main Results:
- The overall mean active elevation improved significantly to 79° postoperatively.
- Active external rotation past neutral improved from 15% preoperatively to 80% in surviving shoulders postoperatively.
- Complications included 15% revision or reoperation for humeral issues and other surgical interventions for hematoma, dislocation, and glenosphere dissociation.
Conclusions:
- Lower trapezius transfer (LTT) combined with reverse shoulder arthroplasty (RSA) using an allograft-prosthetic composite (APC) demonstrates potential for restoring active external rotation.
- This technique offers a viable solution for shoulders with proximal humeral bone loss and posterosuperior cuff deficiency.
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