Feasibility of lower trapezius transfer extended by the infraspinatus fascia for restoration of external rotation in irreparable posterosuperior rotator cuff tears: an anatomical study

Moraiti, Konstantina; Zampeli, Frantzeska; Reinares, Felipe; Gantsos, Apostolos; Valenti, Philippe

doi:10.1007/s00590-020-02817-w

Cited by 5 publications

(4 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, preoperative shoulder FF of <80 O remained a contraindication (i.e. poor prognostic factor) for LTTT due to its inability to reconstitute SSP function [ 4 , 12 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function

Kandeel

2021

J EXP ORTOP

View full text Add to dashboard Cite

Purpose Based on its close anatomic features and nearly-collinear force vector to those of supraspinatus muscle, the current article describes a technique of middle trapezius tendon transfer for reproduction of supraspinatus function in the context of rotator cuff irreparability/re-tear management. Methods While seating the patient in beach-chair position, arthroscopic gleno-humeral examination and sub-acromial decompression are initially performed. Hamstring tendons are harvested and fashioned as flattened quadruple sheet. Through McKenzie approach, infraspinatus and subscapularis tendons are repaired. Then, medial half of middle trapezius insertion tendon is harvested from most medial 5-6 cm of the scapular spine. Through McKenzie approach, hamstring sheet is retrieved via a sub-trapezius/sub-acromial corridor from the scapular wound. Hamstring sheet is re-attached to cuff footprint by double row/suture bridge repair configuration. While retracting the scapula and placing gleno-humeral joint in 45O-abduction/45O-external rotation, hamstring sheet is re-attached to released middle trapezius tendon by non-absorbable sutures. Finally, tendon reconstruct is dynamically-tested in different positions of range of motion. Results Transfer of medial portion of middle trapezius insertion tendon (lengthened by interposition hamstring tendon sheet) to cuff footprint was technically feasible. Dynamic testing showed smooth sub-acromial gliding motion of the tendon reconstruct. Conclusion For reproduction of supraspinatus function, hamstring tendon augmented-middle trapezius tendon transfer to cuff footprint heralds a number of technical and biomechanical advantages; thus offering a potential effective modality of cuff irreparability/re-tear management in relatively young patients of high functional demands. However, current description should be investigated in further biomechanical and clinical studies to validate its long-term outcomes.

show abstract

“…Nevertheless, preoperative shoulder FF of <80 O remained a contraindication (i.e. poor prognostic factor) for LTTT due to its inability to reconstitute SSP function [ 4 , 12 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function

Kandeel

2021

J EXP ORTOP

View full text Add to dashboard Cite

show abstract

“…13,14 In the anatomical topography of the lower trapezius, we distinguish a muscular portion and a tendon portion, highlighting the triangular shape of the tendon portion of the lower trapezius, which is key to identifying the interval between the lower and middle trapezius. 8,15 Furthermore, in the pediatric population, the tendon of lower trapezius prolonged with the thicker periosteum of the spine of the scapula allows to reach directly the footprint of the ISP on the humeral head without the need of tendon graft. 10 To improve the chances of a successful muscle transfer, several important principles must be followed 16 :…”

Section: Anatomymentioning

confidence: 99%

“…In the anatomical topography of the lower trapezius, we distinguish a muscular portion and a tendon portion, highlighting the triangular shape of the tendon portion of the lower trapezius, which is key to identifying the interval between the lower and middle trapezius 8,15…”

Section: Anatomymentioning

confidence: 99%

Surgical Technique: Lower Trapezius Transfer in Paediatric Paralytic Shoulder

Valenti¹,

Dubois²,

Werthel

et al. 2021

Techniques in Hand &Amp; Upper Extremity Surgery

Self Cite

View full text Add to dashboard Cite

The therapeutic management of the paralytic shoulder after an obstetric brachial plexus injury is complex. When nerve repair or neurotization fail, or if the biological times for nerve reconstruction is over, tendon transfer to restore active external rotation of the shoulder becomes the main surgical alternative. The purpose of this manuscript is to describe the surgical technique of the lower trapezius muscle transfer to the infraspinatus muscle, to restore active shoulder external rotation in the child with paralytic shoulder, step by step with details and pearls.

show abstract

“…Biomechanically, the line of pull of the LTT closely mimics the physiological line of pull of the native infraspinatus [ 5 ]. Furthermore, LTT provides sufficient excursion and tension to effectively substitute for the function of the infraspinatus [ 5 , 6 ]. On the other hand, MTT mimics the supraspinatus vector, and therefore, the MTT transfer aims to biomechanically reconstruct the supraspinatus by relocating MTT attached with an interpositional graft from the medial half of the scapular spine to the supraspinatus footprint [ 4 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Combined Lower Trapezius and Middle Trapezius Tendon Transfer for Posterior Superior Irreparable Rotator Cuff Tears: A Case Report

Baek,

Kim,

Kim

2024

jocr

View full text Add to dashboard Cite

Introduction:Irreparable rotator cuff tears (IRCTs) often deteriorate shoulder function, necessitating careful consideration of treatment approaches. While reverse total shoulder arthroplasty (RTSA) is the first line of treatment in patients with arthropathy, preserving the joint is crucial for highly demand patients without arthritis. For those patients, various tendon transfer techniques have been established to address different types of IRCTs, including lower trapezius tendon (LTT) transfer for posterior superior IRCTs (PSIRCTs) and middle trapezius tendon (MTT) transfer for isolated supraspinatus IRCTs (ISIRCTs). Case Report: A 66-year-old male with persistent right shoulder pain and weakness for 2 years, diagnosed with PSIRCTs, sought an alternative to RTSA due to occupational concerns as a restaurant owner. Preoperatively, patients showed limited range of motion (ROM) and weakness, especially in forward elevation (FE) and external rotation (ER). Radiography and magnetic resonance imaging (MRI) scan indicated superior humeral head translation without advanced arthritis and concurrent tears in the supraspinatus and infraspinatus with atrophy. After the consultation, patients underwent a combined transfer of LTT and MTT with a split Achilles tendon allograft in Y-configuration. By post-operative 1 year, the patient exhibited notable improvement, including reduced pain (VAS 4–2), enhanced function (ASES 50–83, Constant 42–78), and increased ROM (FE, 120°–160° and ER, 10°–40°). Radiographic assessments demonstrated an increased in acromiohumeral distance without arthritic progression. Post-operative MRI confirmed tendon integrity, and the patient successfully resumed work at 6 months. Conclusion: A combined transfer of the MTT and LTT with a split Achilles tendon allograft in Y-configuration has been shown to alleviate pain, enhance functional scores, and improve the ROM in patients with PSIRCTs without arthritis. Keywords: Lower trapezius tendon transfer, middle trapezius tendon transfer, irreparable rotator cuff tear, joint preserving, tendon transfer.

show abstract

Feasibility of lower trapezius transfer extended by the infraspinatus fascia for restoration of external rotation in irreparable posterosuperior rotator cuff tears: an anatomical study

Cited by 5 publications

References 22 publications

Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function

Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function

Surgical Technique: Lower Trapezius Transfer in Paediatric Paralytic Shoulder

Combined Lower Trapezius and Middle Trapezius Tendon Transfer for Posterior Superior Irreparable Rotator Cuff Tears: A Case Report

Contact Info

Product

Resources

About