Lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minor

© 2024 Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons.

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 9(2025), 1 vom: 21. Jan., Seite 296-300
1. Verfasser: Gusnowski, Eva (VerfasserIn)
Weitere Verfasser: Wagner, Eric, McRae, Sheila, Cooke, Hayden, Karzon, Anthony, Gottschalk, Michael, MacDonald, Peter, Woodmass, Jarret
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2025
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Athroscopic-assisted Fatty infiltration Goutallier Lower trapezius Magnetic resonance imaging (MRI) Rotator cuff Tendon transfer Teres minor
Beschreibung
Zusammenfassung:© 2024 Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons.
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
Beschreibung:Date Revised 04.02.2025
published: Electronic-eCollection
Citation Status PubMed-not-MEDLINE
ISSN:2666-6383
DOI:10.1016/j.jseint.2024.11.014