Onlay versus Inlay Lower Trapezius Tendon transfer for posterosuperior functional irreparable rotator cuff tears: a 2-year clinical and imaging study

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2026-01-01 Epub Date: 2026-04-14 DOI:10.1016/j.clinsp.2026.100934

Cheng-Pang Yang, Tung-Lung Wu, Louis Yi Lu, Lei Hsia, Poyu Chen, Joe Chih-Hao Chiu

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引用次数: 0

Abstract

Background

This study compared the clinical and radiological outcomes of Onlay and Inlay Lower Trapezius Tendon (LTT) transfer techniques in managing posterosuperior Functional Irreparable Rotator Cuff Tears (FIRCTs).

Methods

This retrospective comparative study included patients who underwent Onlay and Inlay LTT transfer. The inclusion criteria were FIRCTs defined by tendon retraction to the glenoid, fatty infiltration > 2 grade according to Goutallier, and with a positive External Rotation (ER) lag sign. Patients with irreparable subscapularis, dysfunctional deltoid, advanced glenohumeral osteoarthritis, cuff tear arthropathy, and revision surgeries were excluded. Outcomes measures included the active Range Of Motion (ROM), Acromiohumeral Distance (AHD), American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE) score and Constant score.

Results

The study included 39 patients (21 Onlay and 18 Inlay LTT) with at least 2-year follow-up. Both groups achieved significant improvement in active forward elevation from 118.6 ± 57.6° to 145.7 ± 18° in the Onlay group (p = 0.046) and 112.2 ± 49.2° to 140.6 ± 30.6° in the Inlay group (p = 0.046). The ER improved from 31 ± 21.2°to 44.3 ± 16° in the Onlay (p = 0.027) and 29.4 ± 27.1° to 45 ± 16.9° in the Inlay group (p = 0.046). The postoperative AHD was better in the Onlay group (7.3 ± 2.5 vs. 4.8 ± 3.2 mm, p = 0.001). The ASES, SANE, and Constant scores all improved significantly at final follow-up (all p < 0.001) in both groups and reached the Minimal Clinically Important Difference.

Conclusion

Both the onlay and Inlay techniques of LTT transfer effectively improved shoulder function in patients with irreparable posterosuperior rotator cuff tears. The Onlay technique resulted in better AHD at final follow-up.

查看原文本刊更多论文

下斜方肌腱移植治疗后上功能性不可修复的肩袖撕裂：一项2年的临床和影像学研究。

背景：本研究比较了斜方肌下肌腱（LTT）转移技术治疗后上功能性不可修复肩袖撕裂（FIRCTs）的临床和影像学结果。方法：本回顾性比较研究纳入了行嵌体和嵌体LTT转移的患者。纳入标准为肌腱回缩至关节盂，脂肪浸润bbb2级（根据Goutallier），外旋（ER）迟滞征为阳性的firct。不可修复的肩胛下肌、功能不全的三角肌、晚期盂肱骨关节炎、袖撕裂性关节病和翻修手术的患者被排除在外。结果测量包括活动活动度（ROM）、肩肱距离（AHD）、美国肩肘外科医生（ASES）评分、单一评估数值评估（SANE）评分和常数评分。结果：本研究纳入39例患者（21例为内嵌式LTT， 18例为内嵌式LTT），随访至少2年。两组的主动前抬高均有显著改善，Onlay组为118.6±57.6°至145.7±18°（p = 0.046）， Inlay组为112.2±49.2°至140.6±30.6°（p = 0.046）。嵌体组内窥镜从31±21.2°提高到44.3±16°（p = 0.027），嵌体组内窥镜从29.4±27.1°提高到45±16.9°（p = 0.046）。Onlay组术后AHD更好（7.3±2.5 vs. 4.8±3.2 mm, p = 0.001）。在最后随访时，两组的ASES、SANE和Constant评分均显著改善（p < 0.001），达到最小临床重要差异。结论：LTT内嵌和内嵌技术均能有效改善后上肩袖撕裂患者的肩关节功能。在最后的随访中，Onlay技术改善了AHD。

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

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.