Clinical and radiological outcomes after arthroscopic-assisted lower trapezius tendon transfer for isolated irreparable infraspinatus tear.

Abstract

Isolated infraspinatus tears are rare and traditional arthroscopic repairs often result in unsatisfactory outcomes. This study evaluates the clinical and radiological outcomes of arthroscopically-assisted lower trapezius tendon (aLTT) transfer in patients with isolated irreparable infraspinatus tears. This single-center retrospective study reviewed patients who underwent aLTT transfer for irreparable infraspinatus tears with no advanced glenohumeral arthritis. Clinical assessment included visual analog scale (VAS), Constant score, American Shoulder and Elbow Surgeons (ASES) score, and Single Assessment Numeric Evaluation (SANE). Shoulder range of motion was also evaluated. Radiographic evaluation included postoperative magnetic resonance imaging used to evaluate tendon integrity at final follow-up. Two patients were excluded due to loss to follow-up or incomplete data. Six patients were included, with a mean age of 60.7±4.1 years and a mean follow-up duration of 36.7±19.8 months (range, 24-75 months). At the final follow-up, VAS pain scores had improved from 6.0±1.4 to 1.7±0.8 (P<0.05). Functional scores had also improved: Constant score, from 51.5±5.6 to 72.0±6.4; ASES, from 60.5±4.5 to 82.0±6.3; and SANE, from 48.0±6.7 to 79.1±8.0 (P<0.05). Range of motion (ROM) improved in forward elevation (115°±12° to 170°±9°), abduction (95°±15° to 143°±16°), and external rotation at side (22°±11° to 51°±11°) (P<0.05). No progression of glenohumeral arthritis or tendon retears were seen on final follow-up. aLTT transfer significantly reduces pain, improves shoulder function, and restores ROM in patients with isolated irreparable infraspinatus tears. These findings suggest that aLTT transfer is an effective treatment option for this challenging condition. Level of evidence: IV.