Arthroscopic-Assisted Transfer of the Lower Trapezius Tendon for Irreparable Massive Posterosuperior Rotator Cuff Tears

Abstract

AbstractThe management of massive irreparable rotator cuff tears is a challenging problem, especially in young and active patients. While various treatment options have been proposed, including arthroscopic debridement, partial rotator cuff tendon repairs, superior capsular reconstruction, subacromial balloons and ultimately reverse total shoulder arthroplasty, tendon transfers around the shoulder have been shown to be a successful treatment option in a selected group of patients. Historically, the latissimus dorsi tendon (LDT) transfer, which was first described by Gerber in 1988, has been the gold standard tendon transfer for the management of posterosuperior rotator cuff tears, with long-term results demonstrating durable and reliable improvements in shoulder function. More recently, the lower trapezius tendon (LTT) transfer, which has been described by Elhassan, has been proposed as an alternative to the LDT transfer, with theoretically a better line of pull and synergistic muscle activation. In this chapter, we describe our technique for arthroscopic-assisted lower trapezius tendon transfer using an achilles tendon-bone allograft.KeywordsLower trapezius tendon transferMassive irreparable rotator cuff tearShoulder arthroscopy