Abstract
BACKGROUND: To assess the imaging and clinical outcomes of the arthroscopy-assisted lower trapezius transfer (aaLTT) in the setting of irreparable or functionally irreparable rotator cuff tears. METHODS: Bicentric prospective study of patients diagnosed of posterior-superior irreparable or functionally irreparable cuff tears treated with aaLTT and a minimum 2-year follow-up. Patient-reported outcomes, including pain level, range of motion, Constant-Murley Score, American Shoulder and Elbow Surgeons, and Subjective Shoulder Value scores, were recorded preoperatively and postoperatively. X-rays were obtained preoperatively and at the final follow-up to evaluate progression of arthropathy. Postoperative magnetic resonance imaging or ultrasound was utilized to assess integrity of the transferred tendon at the final follow-up. RESULTS: Seventeen consecutive patients, median age of 58 (range, 51-70) years, were included. At a median follow-up of 34.5 months (range, 24-61 months), all patients showed a significant improvement in pain scores and patient-reported outcomes, including Constant-Murley Score and Subjective Shoulder Value scores. Significant improvements in forward flexion and external rotation averaged 30° and 35° (P < .001), respectively, were also obtained. External rotation lag sign and pseudoparalysis were reversed in 88.2% (15/17) and 100% (5/5) of patients, respectively. Postoperative imaging studies showed lateral avulsion of the graft in 6 (35.2%) cases. CONCLUSION: The aaLTT resulted in a significant decrease in pain and improvement in shoulder function with moderate healing rates of the transferred tendon in patients with functional irreparable rotator cuff tear at short-term follow-up.