Arthroscopic Assisted Lower Trapezius Transfer in the Treatment of Irreparable Rotator Cuff Tears

Background: Orthopedic surgeons face a difficult case when a patient has a large, irreversible tear in the rotator cuff that occurs posteriorly. Massive rotator cuff tears involve two or more tendons and have a diameter larger than 5 cm. Conversely, a tendon-bone reposition cannot be performed due to the extent of tendon retraction and tissue degeneration resulting in irreversible damage. Objective: Evaluation of massive irreparable cuff tear by tendon transfer (Arthroscopic Assisted Lower Trapezius Transfer). Patients and Methods: Twenty patients underwent arthroscopically assisted lower trapezius transfer as part of this investigation. There were 7 females and 13 male among the patients analyzed, with an average age of 52.65 years (±4.43 SD) and a range of 46-60 years. Results: The cases that were analyzed had an average American Shoulder and Elbow Surgery Score (ASES score) of 25.75 (±1.74 SD), a constant score of 35.75 (±1.97 SD), an external rotation of 65.5 (±6.05 SD), a forward flexion of 48.5 (±8.13 SD), and an abduction of 42.5 (±6.39 SD). When comparing functional ratings and range of motion across time points, a highly statistically significant difference was seen. One case had a deep infection, and two others experienced postoperative restricted improvement of range of motion; these three cases accounted for 15% of the total problems. Conclusion: For patients with large, irreversible rotator cuff tears, arthroscopic-assisted lower trapezius tendon transfer is a safe and effective approach that can enhance their function significantly.