Defining Indications for Rotator Cuff Repair: Predictors of Failure of Nonoperative Treatment of Chronic, Symptomatic, Full-Thickness Rotator Cuff Tears

Abstract

failed to restore the intact compressive force at all rotational and abduction angles (P < .005). At neutral humeral rotation at 0 abduction, the rotator cuff tear caused an anteriorly directed force andwas restored by the trapezius transfer 24N load (P < .05), whereas the latissimus transfer did not show any significant difference from the cuff tear condition (Figure 2). Conclusion: Both the lower trapezius transfer and the latissimus dorsi transfer are beneficial in restoring rotational balance of the humerus due to muscle loading and glenohumeral kinematics. The trapezius transfer was able to provide a better AP centering force than the latissimus transfer and restored contact forces to the intact condition. The increase in contact forces seen with the trapezius transfer, however, may be more problematic in patients with subtle osteoarthritis. Overall, we found that the lower trapezius transfer is biomechanically superior to the latissimus transfer in restoring native glenohumeral biomechanics. Clinical studies to evaluate the results of the trapezius transfer are warranted. Level of evidence: Basic Science Study, Biomechanical, Cadaveric model.