Description of Surgery Technique of The Lower Trapezius Transfer with Semitendinosus and Gracilis Tendon Graft for The Treatment of Massive or Irreparable Rotator Cuff Tear

Abstract

Background: The current work describes a surgery technique where the autograft of hamstring tendon (semitendinosus and gracilis) was used as adjuvant in the transfer of the lower trapezius for the treatment of massive or irreparable rotator cuff tear. There is a theoretical advantage that the graft takes a greater footprint area in the greater tuberosity of the humerus corresponding to the infraspinatus, thus recreating the native anatomy more accurately.

Methods: The autograft of hamstring tendon was attached to the lower trapezius through an incision of 4cm in the middle third of the scapular spine and transferred to the footprint of the infraspinatus in the greater tuberosity of the humerus, where it is attached through the second incision under the lateral acromial margin.

Result: The patient was examined preoperatively and after 6 months of follow-up, and his pain, according to the Visual Analogue Scale, varied from 8 to 3, the range of motion improved in abduction from 100° to 120°, external rotation from 30° to 50° and flexion from 110° to 150°. The Shoulder Subjective Value ranged between 60 and 80% and the Disabilities of the Arm, Shoulder and Hand score went from 45 to 18.3.

Conclusion: The lower trapezius transfer with autograft of hamstring tendons is a low-cost and relatively reproducible surgical technique with theoretical biomechanical and anatomic advantages that may bring about better function results.

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