Abstract
Background: Massive and irreparable rotator cuff tears (MIRCTs) cause destabilization of the glenohumeral joint by altering the anteroposterior forces coupling, compromising the shoulder function, especially at the expense of the active external rotation and significant pain. Among the therapeutic alternatives, lower trapezius transfer has shown promising results in the short term, with only a few studies providing evidence of the lasting integrity of the repair.
Aims: The purpose of this study was to describe the mid-term clinical, radiologic, and patient-reported outcomes of lower trapezius transfer in patients with MIRCTs.
Methods: This was a prospective longitudinal study of patients with MIRCT with more than six months of symptoms with no response to conservative management and treated with lower trapezius transfer in three specialized centers between 2018 and 2022. Data about the range of movement, imaging studies, functional assessment through the American Shoulder and Elbow Surgeons score, and pain level evaluation through a visual analog scale was collected during follow-ups at 12, 24, 48, and 60 months. Descriptive and comparative analyses of before and after surgery outcomes are presented.
Results: Fifteen patients were included in the series, with a median age of 59 years and 66.7% males. At 48 and 60 months postoperatively, patients who were assessed presented significant improvement in the range of movement, American Shoulder and Elbow Surgeons score, and pain level concerning the presurgical parameters. There was no retearing, and only one patient presented a 20% progression of glenohumeral arthrosis at about 30 months postoperatively.
Conclusion: Lower trapezius transfer in patients with MIRCTs showed satisfactory clinical, radiologic, and functional outcomes in the mid-term, with no retearing and very low progression of degenerative changes. These results provide evidence of the lasting effects of lower trapezius transfer in treating MIRCTs.