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Introduction <p>Shoulder dysfunction, including loss of active forward elevation (FE) and external rotation (ER), is challenging in posterosuperior irreparable rotator cuff tears (PSIRCTs). We compared the clinical outcomes of reverse shoulder arthroplasty (RSA) and arthroscopy-assisted lower trapezius tendon transfer (aLTT) in PSIRCTs patients without arthritis.</p> Material and Methods <p>Approximately 29 patients were included in each group (RSA group and aLTT group), using retrospective propensity score matching based on demographic variables with a minimum 2-year follow-up period. Clinical results were compared with the visual analogue scale score, Constant shoulder score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and activities of daily living requiring active external rotation (ADLER) score, active range of motion and rotational strength between the two groups. Subsequently, the arthritic change of shoulder joint was evaluated using the acromiohumeral distance (AHD) and Hamada grade.</p> Results <p>The clinical outcomes were significantly improved in both groups. However, ADLER score (20.6 ± 4.0 vs. 27.3 ± 3.7, <i>p</i> &lt; .001), ER at 0° of abduction (34.2 ± 13.2 vs. 47.5 ± 11.1, <i>p</i> &lt; .001), ER at 90° of abduction (49.6 ± 15.4 vs. 66.5 ± 19.5, <i>p</i> &lt; .001) and ER strength (16.4 ± 4.0 vs. 24.1 ± 9.1, <i>p</i> &lt; .001) of aLTT group were significantly better than that of RSA group. No significant increase of AHD and no significant progression of arthritis change were observed in aLTT group.</p> Conclusions <p>Although both RSA and aLLT improved overall patient outcomes postoperatively, aLTT was superior in clinical scores, notably the ADLER score, active ER, and ER strength in PSIRCTs patients without arthritis. These findings suggest that aLTT could be a first-line joint-preserving treatment option for PSIRCTs patients without arthritis, given the longevity and related complications associated with arthroplasty.</p> Level of evidence <p>III.</p>

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Efficacy of arthroscopic assisted lower trapezius tendon transfer versus reverse shoulder arthroplasty in patients with posterosuperior irreparable rotator cuff tear without arthritis: retrospective propensity score matching study

  • 期刊论文

  • 发表日期：

    2025年5月12日

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  • Chang Hee Baek,
  • Chaemoon Lim,
  • Jung Gon Kim,
  • Bo Taek Kim,
  • Seung Jin Kim

摘要

Introduction

Shoulder dysfunction, including loss of active forward elevation (FE) and external rotation (ER), is challenging in posterosuperior irreparable rotator cuff tears (PSIRCTs). We compared the clinical outcomes of reverse shoulder arthroplasty (RSA) and arthroscopy-assisted lower trapezius tendon transfer (aLTT) in PSIRCTs patients without arthritis.

Material and Methods

Approximately 29 patients were included in each group (RSA group and aLTT group), using retrospective propensity score matching based on demographic variables with a minimum 2-year follow-up period. Clinical results were compared with the visual analogue scale score, Constant shoulder score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and activities of daily living requiring active external rotation (ADLER) score, active range of motion and rotational strength between the two groups. Subsequently, the arthritic change of shoulder joint was evaluated using the acromiohumeral distance (AHD) and Hamada grade.

Results

The clinical outcomes were significantly improved in both groups. However, ADLER score (20.6 ± 4.0 vs. 27.3 ± 3.7, p < .001), ER at 0° of abduction (34.2 ± 13.2 vs. 47.5 ± 11.1, p < .001), ER at 90° of abduction (49.6 ± 15.4 vs. 66.5 ± 19.5, p < .001) and ER strength (16.4 ± 4.0 vs. 24.1 ± 9.1, p < .001) of aLTT group were significantly better than that of RSA group. No significant increase of AHD and no significant progression of arthritis change were observed in aLTT group.

Conclusions

Although both RSA and aLLT improved overall patient outcomes postoperatively, aLTT was superior in clinical scores, notably the ADLER score, active ER, and ER strength in PSIRCTs patients without arthritis. These findings suggest that aLTT could be a first-line joint-preserving treatment option for PSIRCTs patients without arthritis, given the longevity and related complications associated with arthroplasty.

Level of evidence

III.