Arthroscopy-Assisted Lower Trapezius Transfer Using Doubled Peroneus Longus Autograft as an Interposition Graft

Massive irreparable rotator cuff tears, particularly those involving the posterosuperior cuff, pose significant functional challenges. Arthroscopy-assisted lower trapezius transfer has emerged as the preferred treatment for patients with these tears, especially in the absence of glenohumeral arthritis. Although traditional techniques often use Achilles tendon allografts, limitations in cost and availability in developing countries necessitate the development of innovative alternatives. This article describes a surgical technique that uses a doubled peroneus longus autograft. We detail the surgical steps, technical nuances, and potential advantages of this approach.