Lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minor
Background: This study compares postoperative outcomes of lower trapezius tendon transfers (LTTTs) in massive irreparable rotator cuff (RC) tears based on the degree of teres minor (TM) fatty infiltration. Methods: In this prospective longitudinal observational study, patients with massive RC tears...
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Elsevier
2025-01-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638324004730 |
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| author | Eva Gusnowski, MD, FRCSC Eric Wagner, MD Sheila McRae, PhD Hayden Cooke, MD Anthony Karzon, MD Michael Gottschalk, MD Peter MacDonald, MD, FRCSC Jarret Woodmass, MD, FRCSC |
| author_facet | Eva Gusnowski, MD, FRCSC Eric Wagner, MD Sheila McRae, PhD Hayden Cooke, MD Anthony Karzon, MD Michael Gottschalk, MD Peter MacDonald, MD, FRCSC Jarret Woodmass, MD, FRCSC |
| author_sort | Eva Gusnowski, MD, FRCSC |
| collection | DOAJ |
| description | Background: This study compares postoperative outcomes of lower trapezius tendon transfers (LTTTs) in massive irreparable rotator cuff (RC) tears based on the degree of teres minor (TM) fatty infiltration. Methods: In this prospective longitudinal observational study, patients with massive RC tears undergoing arthroscopic-assisted LTTT by two surgeons were screened. TM fatty infiltration on preoperative magnetic resonance imaging was graded using the Goutallier classification. Two groups were created as follows: group A included grades 0 and 1 (no or little fatty infiltration), and group B included grades 2 to 4 (moderate-to-severe fatty infiltration). Participants completed the Single Assessment Numeric Evaluation (SANE) score preoperatively, and 12- and/or 24 months postoperatively along with a clinical assessment. Independent t-tests compared groups, and paired t-tests compared pre-vs. postoperative results. Significance was defined as P < .05. Results: There were 47 patients in group A and 19 in group B. No group differences were found in preoperative SANE score, forward elevation or active external rotation (ER). Both groups showed significant postoperative improvements in SANE score with no differences between the groups. An ER lag sign was observed in 18/47 patients (38.3%) in group A and 11/19 patients (57.9%) in group B (P = .177). Preoperative ER strength was significantly different in group A (2.9 kg) vs. group B (0.7 kg; P = .001), but postoperative ER strength was similar (P = .931). Conclusion: LTTT is a suitable salvage procedure regardless of the degree of TM fatty infiltration and should be considered an alterative procedure to latissimus dorsi tendon transfer in patients with high-grade TM fatty infiltration. |
| format | Article |
| id | doaj-art-fa37df1d9e5f495589b852049c9fbe6a |
| institution | Kabale University |
| issn | 2666-6383 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj-art-fa37df1d9e5f495589b852049c9fbe6a2025-01-12T05:26:06ZengElsevierJSES International2666-63832025-01-0191296300Lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minorEva Gusnowski, MD, FRCSC0Eric Wagner, MD1Sheila McRae, PhD2Hayden Cooke, MD3Anthony Karzon, MD4Michael Gottschalk, MD5Peter MacDonald, MD, FRCSC6Jarret Woodmass, MD, FRCSC7Orthopaedic Surgery, Pan Am Clinic, Winnipeg, MB, CanadaDivision of Orthopedic Surgery, Department of Surgery, Emory University, Atlanta, GA, USADivision of Orthopaedics, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada; Pan Am Clinic Foundation, Winnipeg, MB, CanadaDivision of Orthopedic Surgery, Department of Surgery, Emory University, Atlanta, GA, USADivision of Orthopedic Surgery, Department of Surgery, Emory University, Atlanta, GA, USADivision of Orthopedic Surgery, Department of Surgery, Emory University, Atlanta, GA, USAOrthopaedic Surgery, Pan Am Clinic, Winnipeg, MB, Canada; Division of Orthopaedics, Department of Surgery, University of Manitoba, Winnipeg, MB, CanadaOrthopaedic Surgery, Pan Am Clinic, Winnipeg, MB, Canada; Division of Orthopaedics, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada; Corresponding author: Jarret Woodmass, MD, FRCSC, Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB R3M 3EG, Canada.Background: This study compares postoperative outcomes of lower trapezius tendon transfers (LTTTs) in massive irreparable rotator cuff (RC) tears based on the degree of teres minor (TM) fatty infiltration. Methods: In this prospective longitudinal observational study, patients with massive RC tears undergoing arthroscopic-assisted LTTT by two surgeons were screened. TM fatty infiltration on preoperative magnetic resonance imaging was graded using the Goutallier classification. Two groups were created as follows: group A included grades 0 and 1 (no or little fatty infiltration), and group B included grades 2 to 4 (moderate-to-severe fatty infiltration). Participants completed the Single Assessment Numeric Evaluation (SANE) score preoperatively, and 12- and/or 24 months postoperatively along with a clinical assessment. Independent t-tests compared groups, and paired t-tests compared pre-vs. postoperative results. Significance was defined as P < .05. Results: There were 47 patients in group A and 19 in group B. No group differences were found in preoperative SANE score, forward elevation or active external rotation (ER). Both groups showed significant postoperative improvements in SANE score with no differences between the groups. An ER lag sign was observed in 18/47 patients (38.3%) in group A and 11/19 patients (57.9%) in group B (P = .177). Preoperative ER strength was significantly different in group A (2.9 kg) vs. group B (0.7 kg; P = .001), but postoperative ER strength was similar (P = .931). Conclusion: LTTT is a suitable salvage procedure regardless of the degree of TM fatty infiltration and should be considered an alterative procedure to latissimus dorsi tendon transfer in patients with high-grade TM fatty infiltration.http://www.sciencedirect.com/science/article/pii/S2666638324004730Lower trapeziusTendon transferRotator cuffMagnetic resonance imaging (MRI)GoutallierFatty infiltration |
| spellingShingle | Eva Gusnowski, MD, FRCSC Eric Wagner, MD Sheila McRae, PhD Hayden Cooke, MD Anthony Karzon, MD Michael Gottschalk, MD Peter MacDonald, MD, FRCSC Jarret Woodmass, MD, FRCSC Lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minor JSES International Lower trapezius Tendon transfer Rotator cuff Magnetic resonance imaging (MRI) Goutallier Fatty infiltration |
| title | Lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minor |
| title_full | Lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minor |
| title_fullStr | Lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minor |
| title_full_unstemmed | Lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minor |
| title_short | Lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minor |
| title_sort | lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minor |
| topic | Lower trapezius Tendon transfer Rotator cuff Magnetic resonance imaging (MRI) Goutallier Fatty infiltration |
| url | http://www.sciencedirect.com/science/article/pii/S2666638324004730 |
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