Lower Trapezius Transfer Technique for Rotator Cuff Tear: Insights from General Surgery

Abstract

Abstract
The current study presents a surgical innovation in the realm of general surgery, focusing on the utilization of hamstring tendon autograft (specifically semitendinosus and gracilis) as an adjunct in the transfer of the lower trapezius for addressing massive or irreparable rotator cuff tears. This technique offers a theoretical advantage by providing a larger footprint area on the greater tuberosity of the humerus, aligning more closely with the native anatomy. The procedure involves attaching the hamstring tendon autograft to the lower trapezius through a 4cm incision along the middle third of the scapular spine. Subsequently, the tendon is transferred to the infraspinatus footprint on the greater tuberosity of the humerus via a second incision beneath the lateral acromial margin. Patients underwent preoperative assessments and were followed up after 6 months post-surgery. Results indicated significant improvements across various parameters: pain levels, as measured by the Visual Analogue Scale, decreased from 8 to 3; range of motion increased in abduction from 100° to 120°, external rotation from 30° to 50°, and flexion from 110° to 150°. Additionally, Shoulder Subjective Value scores ranged between 60% and 80%, while Disabilities of the Arm, Shoulder, and Hand scores decreased from 45 to 18.3. The lower trapezius transfer with hamstring tendon autograft emerges as a cost-effective and relatively standardized surgical approach. Its biomechanical and anatomical advantages hold promise for achieving superior functional outcomes in patients undergoing treatment for rotator cuff tears.