Middle trapezius tendon transfer for isolated irreparable supraspinatus tears shows favorable outcomes despite subscapularis tear

IF 1.8 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2026-05-01 Epub Date: 2025-12-16 DOI:10.1016/j.jor.2025.12.031

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

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引用次数: 0

Abstract

Introduction

Middle trapezius tendon (MTT) transfer has emerged as a viable treatment option for isolated irreparable supraspinatus tears (IIST). This study aimed to compare the clinical outcomes of MTT transfer between patients with intact subscapularis and those with concomitant subscapularis tears.

Methods

A retrospective review was conducted on patients who underwent arthroscopically assisted MTT transfer for IISTs between January 2018 and December 2023, with a minimum follow-up of 24 months. Patients were stratified into two groups: subscapularis intact and subscapularis tear (Lafosse type I–III, treated with debridement or repair). Patients with incomplete follow-up or missing data were excluded. Clinical outcomes—including pain (VAS), functional scores (Constant and ASES), active range of motion (ROM), and strength—were evaluated pre- and postoperatively. Radiologic assessments included acromiohumeral distance (AHD) and Hamada grade for glenohumeral arthritis. Minimal clinically important differences (MCID) and complications were also recorded.

Results

After excluding five patients, 61 patients were included (48 Subscapularis-intact, 13 Subscapularis-tear). Both groups demonstrated significant postoperative improvements in VAS, Constant, ASES scores, ROM and strength in forward elevation and abduction. Preoperative internal rotation ROM and strength were lower in the subscapularis-tear group, but postoperative values were comparable between the groups. MCID achievement rates exceeded 90 % in both groups. Complications included one retear and one minor progression of arthritis in the subscapularis-tear group, one infection in the subscapularis-tear group, and one retear in the subscapularis-intact group.

Conclusion

MTT transfer provides significant improvements in pain, function, forward elevation, and abduction in patients with IISTs, regardless of preoperative subscapularis integrity. Although preoperative internal rotation ROM and strength were lower in the subscapularis-tear group, postoperative recovery restored these measures to levels comparable with the subscapularis-intact group, supporting the efficacy of MTT transfer even in the presence of concomitant subscapularis pathology.

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中斜方肌腱转移治疗孤立的不可修复的冈上肌撕裂，尽管肩胛下肌撕裂，但效果良好

中斜方肌腱（MTT）转移已成为孤立的不可修复冈上肌撕裂（IIST）的可行治疗选择。本研究旨在比较肩胛下肌完整患者和肩胛下肌同时撕裂患者的MTT转移的临床结果。方法回顾性分析2018年1月至2023年12月接受关节镜辅助MTT转移治疗的iist患者，随访时间至少为24个月。患者分为两组：肩胛下肌完整组和肩胛下肌撕裂组（Lafosse I-III型，清创或修复）。排除随访不完整或资料缺失的患者。临床结果-包括疼痛（VAS）、功能评分（Constant和ASES）、活动范围（ROM）和力量-在术前和术后进行评估。放射学评估包括肩肱距离（AHD）和滨田分级的肩关节关节炎。最小临床重要差异（MCID）和并发症也被记录。结果排除5例患者后，纳入61例患者（肩胛下肌完整者48例，肩胛下肌撕裂者13例）。两组术后VAS、Constant、ASES评分、ROM、前仰和外展强度均有显著改善。肩胛下肌撕裂组术前内旋活动度和强度较低，但术后两组间具有可比性。两组的MCID成功率均超过90%。并发症包括肩胛下撕裂组1例复发和1例轻微关节炎进展，肩胛下撕裂组1例感染，肩胛下完整组1例复发。结论mtt转移可显著改善iist患者的疼痛、功能、前抬和外展，而无需考虑术前肩胛下肌完整性。尽管肩胛下肌撕裂组术前内旋ROM和强度较低，但术后恢复将这些指标恢复到与肩胛下肌完整组相当的水平，即使存在肩胛下肌病变，也支持MTT转移的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.