Treatment Innovations for Massive & Irreparable Rotator Cuff Tears (AANA22)-Lower Trapezius Transfer

Video Transcription

Video Summary

The speaker discusses the use of lower trapezius tendon transfer to treat massive irreparable posterior superior rotator cuff tears characterized by advanced fatty atrophy and weakness of key shoulder muscles, particularly when prior superior capsular reconstruction (SCR) has failed. Emphasizing the importance of restoring the shoulder's force couple for stability and function, they explain why the lower trapezius is biomechanically ideal due to its matching line of pull, tension, and excursion to the deficient rotator cuff muscles. The technique involves harvesting the lower trapezius tendon, augmenting it with an Achilles tendon allograft, and arthroscopically attaching it to the rotator cuff footprint to restore external rotation and shoulder stability. Outcomes demonstrated active, functional recovery of shoulder motion. The procedure has evolved from open to arthroscopic-assisted surgery and shows promise for patients with failed SCR without resorting to reverse arthroplasty. The speaker concludes by citing positive clinical results and encouraging its use in appropriate cases.

Asset Caption

Bassem Elhassan, M.D.

Keywords

lower trapezius tendon transfer

massive irreparable rotator cuff tears

posterior superior rotator cuff

superior capsular reconstruction failure

Achilles tendon allograft augmentation

arthroscopic shoulder surgery