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German Congress of Orthopaedics and Traumatology (DKOU 2024)

22. - 25.10.2024, Berlin

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Combined arthroscopic-assisted lower trapezius tendon transfer and superior capsule reconstruction for massive irreparable posterior-superior rotator cuff tears

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  • presenting/speaker Emanuele Maggini - University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Brescia, Italy
  • Alessandro Colosio - University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Brescia, Italy
  • Marcello Motta - University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Brescia, Italy
  • Maristella Francesca Saccomanno - University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Brescia, Italy
  • Giuseppe Milano - University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Brescia, Italy

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2024). Berlin, 22.-25.10.2024. Düsseldorf: German Medical Science GMS Publishing House; 2024. DocAB44-3448

doi: 10.3205/24dkou198, urn:nbn:de:0183-24dkou1981

Published: October 21, 2024

© 2024 Maggini et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives: Treatment of massive irreparable rotator cuff tears (MIRCT) is challenging. A surgical technique combining arthroscopic-assisted lower trapezius tendon transfer (LTT) and superior capsule reconstruction (SCR) has been recently proposed to restore motion and strength. The aim of the present study was to evaluate the clinical outcomes of this combined procedure. The hypothesis of the study was that a combined LTT and SCR could improve subjective and functional outcomes.

Methods: A retrospective study on prospective collected data was conducted. Patients who underwent a combined arthroscopic-assisted LTT and SCR for a postero-superior MIRCT were included. Exclusion criteria were rotator cuff tear arthropathy > stage 3 (Hamada classification), irreparable subscapularis tendon tear, fatty infiltration of teres minor (> grade 3), deltoid deficiency. All patients underwent the same surgical technique and rehabilitation protocol. Primary outcome was the American Shoulder and Elbow Surgeons (ASES) score. Secondary outcomes were the Quick-Disabilities of the Arm, Shoulder and Hand (Quick-DASH) and the Western Ontario Rotator Cuff Index (WORC) scores. A paired t-test was used to compare pre and postoperative outcomes. Significance was set at p < 0.05.

Results and conclusion: Ten patients (6 male, 4 female) were included. Mean age (± SD) of patients was 64 ± 5.3 years. Mean follow-up was 12 ± 1.7 months. All clinical outcomes showed significant improvements (p < 0.0001).

Arthroscopic-assisted LTT combined with SCR for the treatment of MIRCTs provides satisfactory subjective and functional outcomes.

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