Dataset Information

Arthroscopic-Assisted Lower Trapezius Tendon Transfer for Massive Irreparable Posterosuperior Rotator Cuff Tears Using an Achilles Tendon-Bone Allograft.

ABSTRACT: The lower trapezius tendon (LTT) transfer has been described for the management of irreparable posterosuperior rotator cuff tears. Here we describe our technique of an arthroscopic-assisted LTT transfer using an Achilles tendon-bone allograft. This technique allows for augmentation of the tendon transfer using an Achilles tendon allograft while also keeping the calcaneal bone insertion, which allows for added bony fixation into the humerus and also minimizing the risk of the "killer turn" phenomenon at the aperture of fixation.

SUBMITTER: Ek ET

PROVIDER: S-EPMC7695616 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Arthroscopic-Assisted Lower Trapezius Tendon Transfer for Massive Irreparable Posterosuperior Rotator Cuff Tears Using an Achilles Tendon-Bone Allograft.

Ek Eugene T ET Lording Timothy T McBride Andrew P AP

Arthroscopy techniques 20201120 11

The lower trapezius tendon (LTT) transfer has been described for the management of irreparable posterosuperior rotator cuff tears. Here we describe our technique of an arthroscopic-assisted LTT transfer using an Achilles tendon-bone allograft. This technique allows for augmentation of the tendon transfer using an Achilles tendon allograft while also keeping the calcaneal bone insertion, which allows for added bony fixation into the humerus and also minimizing the risk of the "killer turn" phenom ...[more]

PMID: 33294337

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Project description:PurposeTo evaluate functional outcomes, return to work, and reoperations associated with lower trapezius tendon transfer (LTT) for irreparable rotator cuff tears.MethodsThis is a retrospective study performed by a single surgeon with minimum 1-year follow-up. LTT was performed using an open (n = 9; 60%) or arthroscopically assisted (n = 6, 40%) technique. Outcomes included failure rate, range of motion, satisfaction, return to work, and pre- and postoperative functional scores, as well as American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, and the Simple Shoulder Test.ResultsFifteen patients were included. LTT was performed using an open or arthroscopically assisted technique. Mean age was 52 (range 31-62 years), 13 (92.9%) were manual laborers, and 9 (60%) had a worker's compensation claim. Three patients (20%) underwent conversion to reverse shoulder arthroplasty. Of the remaining 12 patients, there were significant improvements in American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, and Simple Shoulder Test at 24.1 ± 9.6 (range 12-38.5) months. Active forward elevation, abduction, and external rotation were all significantly improved. Postoperative satisfaction ratings indicated 67% of the revision-free cohort was "very satisfied" and 33% was "somewhat satisfied" with their outcome. Seven (50%) returned to full duty, 4 (28.6%) returned to modified duty, and 3 (21.4%) were unable to return to work. Two patients (open techniques) underwent a superficial wound debridement for seroma and wound breakdown.ConclusionsLTT results in successful clinical outcomes with a high rate of return to work in a challenging patient population. However, only 67% of patients rated themselves as "very satisfied," and 20% of patients were revised to reverse shoulder arthroplasty before 1 year. Limited preoperative active forward elevation (<90°) appears to predict poor functional results and risk for reoperation.Level of evidenceLevel IV, therapeutic case series.

Dataset Information

Arthroscopic-Assisted Lower Trapezius Tendon Transfer for Massive Irreparable Posterosuperior Rotator Cuff Tears Using an Achilles Tendon-Bone Allograft.

Publications

Arthroscopic-Assisted Lower Trapezius Tendon Transfer for Massive Irreparable Posterosuperior Rotator Cuff Tears Using an Achilles Tendon-Bone Allograft.

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