Superior Capsule Reconstruction and Lower Trapezius Transfer for Irreparable Posterior-Superior Rotator Cuff Tear

Abstract

Case:A 49-year-old right-hand-dominant male weightlifter was referred with persistent left shoulder pain, weakness, and range of motion limitations after failed arthroscopic rotator cuff repair and subsequent arthroscopic debridement for a massive posterior-superior supraspinatus and infraspinatus tear. The patient underwent a superior capsular reconstruction (SCR) with lower trapezius (LT) transfer to re-establish rotator cuff function.Conclusion:LT transfer in addition to SCR may be a promising modality to treat massive, irreparable posterior-superior rotator cuff tears in young adults. LT transfer can optimize external rotation, whereas SCR may more adequately address pain and forward elevation.

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

“…There have been several successful reports that involve a combination of two procedures to address IRCTs. For instance, there have been reports of successful combinations of LTT transfer with superior capsular reconstruction [ 14 ] and LTT transfer with biceps superior capsule reconstruction [ 15 ]. In addition, the versatility of RTSA is demonstrated in its combination with l’Episcopo transfer [ 16 ].…”

Combined Arthroscopic-Assisted Lower Trapezius Tendon Transfer and Superior Capsule Reconstruction for Massive Irreparable Posterior-Superior Rotator Cuff Tears: Surgical Technique

“…In a recent case report, McCormick et al. 24 also proposed the combination of SCR and LTT in a 49-year-old male affected by a massive rotator cuff re-tear. The authors used a dermal graft for SCR and an Achilles tendon allograft as a graft extension for the LTT.…”