Chang Hee Baek1, Jung Gon Kim2. 1. Department of Orthopaedic Surgery, Yeosu Baek Hospital, Yeoseo 1-ro, 59709, Yeosu-si, Jeollanam-do, Republic of Korea. yeosubaek@gmail.com. 2. Department of Orthopaedic Surgery, Yeosu Baek Hospital, Yeoseo 1-ro, 59709, Yeosu-si, Jeollanam-do, Republic of Korea.
Abstract
INTRODUCTION: Middle trapezius tendon (MTT) transfer has been proposed as a feasible option for managing isolated irreparable supraspinatus tears (IISTTs). However, no clinical study has been attempted. This study aimed to evaluate clinical and radiologic outcomes of arthroscopic-assisted MTT transfer in patients with IISTTs. METHODS: This retrospective study included patients who underwent arthroscopic-assisted MTT transfer using fascia lata autograft for IISTTs. Clinical outcomes, including pain visual analog scale (VAS), Constant, American Shoulder and Elbow Society (ASES), University of California Los Angeles (UCLA) shoulder scores and active range of motion (aROM), were assessed. Radiographic analyses included the acromiohumeral distance (AHD), Hamada grade, and transferred tendon integrity at the final follow-up. RESULTS: Twenty-two patients (mean age: 63.3 ± 6.8 [51‒74] years; mean follow-up period: 28.9 ± 4.9 [24‒44] months) met the study criteria. The mean VAS, Constant, ASES, and UCLA scores improved postoperatively at the final follow-up (p < 0.001). The mean aROMs for forward flexion and abduction were significantly increased postoperatively. No significant changes of AHD (p = 0.105) and Hamada grade (p = 0.815) were observed postoperatively. One patient had a re-tear of the transferred tendon at the footprint site at the final follow-up. CONCLUSION: In this minimum 2-year follow-up study of the novel aMTT transfer using fascia lata autograft, we found significant improvement in pain relief, clinical scores, and active forward flexion and abduction. Additionally, no significant progression of cuff tear arthropathy was observed at the final follow-up. Therefore, aMTT transfer could be a promising treatment option for patients with IISTTs. However, further multicenter and long-term trials are needed to verify its effectiveness. LEVEL OF EVIDENCE: Retrospective case series, level IV.
INTRODUCTION: Middle trapezius tendon (MTT) transfer has been proposed as a feasible option for managing isolated irreparable supraspinatus tears (IISTTs). However, no clinical study has been attempted. This study aimed to evaluate clinical and radiologic outcomes of arthroscopic-assisted MTT transfer in patients with IISTTs. METHODS: This retrospective study included patients who underwent arthroscopic-assisted MTT transfer using fascia lata autograft for IISTTs. Clinical outcomes, including pain visual analog scale (VAS), Constant, American Shoulder and Elbow Society (ASES), University of California Los Angeles (UCLA) shoulder scores and active range of motion (aROM), were assessed. Radiographic analyses included the acromiohumeral distance (AHD), Hamada grade, and transferred tendon integrity at the final follow-up. RESULTS: Twenty-two patients (mean age: 63.3 ± 6.8 [51‒74] years; mean follow-up period: 28.9 ± 4.9 [24‒44] months) met the study criteria. The mean VAS, Constant, ASES, and UCLA scores improved postoperatively at the final follow-up (p < 0.001). The mean aROMs for forward flexion and abduction were significantly increased postoperatively. No significant changes of AHD (p = 0.105) and Hamada grade (p = 0.815) were observed postoperatively. One patient had a re-tear of the transferred tendon at the footprint site at the final follow-up. CONCLUSION: In this minimum 2-year follow-up study of the novel aMTT transfer using fascia lata autograft, we found significant improvement in pain relief, clinical scores, and active forward flexion and abduction. Additionally, no significant progression of cuff tear arthropathy was observed at the final follow-up. Therefore, aMTT transfer could be a promising treatment option for patients with IISTTs. However, further multicenter and long-term trials are needed to verify its effectiveness. LEVEL OF EVIDENCE: Retrospective case series, level IV.
Authors: D Goutallier; L De Abreu; J-M Postel; P Le Guilloux; C Radier; S Zilber Journal: Orthop Traumatol Surg Res Date: 2011-10-20 Impact factor: 2.256
Authors: Patrick J Denard; Paul C Brady; Christopher R Adams; John M Tokish; Stephen S Burkhart Journal: Arthroscopy Date: 2017-11-13 Impact factor: 4.772
Authors: Gregory L Cvetanovich; Anirudh K Gowd; Joseph N Liu; Benedict U Nwachukwu; Brandon C Cabarcas; Brian J Cole; Brian Forsythe; Anthony A Romeo; Nikhil N Verma Journal: J Shoulder Elbow Surg Date: 2019-01-24 Impact factor: 3.019