Arthroscopically assisted lower trapezius tendon transfer results in similar clinical and structural outcomes for patients ≤60 and ≥70 years old.

Abstract

Arthroscopically assisted lower trapezius tendon (aLTT) transfer has emerged as an effective surgical option for patients with posterior-superior irreparable rotator cuff tears (PSIRCTs) who primarily complain of external rotation weakness and lag signs, in the absence of arthritis. The purpose of this study is to compare the clinical and structural outcome among different age groups in aLTT transfer for PSIRCTs. We retrospectively reviewed patients who underwent aLTT transfer for PSIRCTs between May 2017 and September 2021. We included patients with PSIRCTs, minimal glenohumeral arthritis (Hamada grade ≤ 2), poor muscle quality (Goutallier grades ≥3), and a minimum follow-up of 2 years. Patients lacking a minimum of 2-year follow-up data and a postoperative magnetic resonance imaging (MRI) scan were excluded. For the purpose of the study, 3 groups were created: group Total including all ages, group A consisting of patients aged ≤60 years, and group B consisting of patients aged ≥70 years. We compared patient-reported outcome scores (visual analog scale [VAS], Constant score, University of California-Los Angeles [UCLA] shoulder score, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form [ASES], Activities of Daily Living Requiring Active External Rotation [ADLER]), pre- and postoperative range of motion (ROM), acromiohumeral distance (AHD), Hamada grade, graft integrity on postoperative MRI, and complications among the groups. Eighty-four patients underwent aLTT transfer (51 with Achilles tendon allografts and 33 with fascia lata autografts), with a mean follow-up of 43.7 ± 14.6 months. There was significant improvement in VAS, Constant, UCLA, ASES, and ADLER scores, and ROM in the entire cohort. When comparing group A (n = 23) and group B (n = 19), there were no significant differences in patient-reported outcomes, ROM, AHD, and Hamada grade. Additionally, we observed comparable clinical results, with similar rates of complications such as retear, postoperative stiff shoulder, and revision surgery between the groups. The current study demonstrates that aLTT transfer for PSIRCTs with minimal glenohumeral arthritis yields similar results between group A and group B. Additionally, the 2 different age groups did not show significantly different clinical results when compared to the entire cohort. Our findings contribute to a more comprehensive understanding of the applicability of aLTT transfer across different age groups, emphasizing its potential as a viable treatment option for a broader patient population.