Preoperative acromiohumeral distance does not influence clinical outcomes after middle trapezius tendon transfer for irreparable supraspinatus tears.

Abstract

Purpose: This study compared clinical outcomes after arthroscopically assisted middle trapezius tendon (MTT) transfer for irreparable supraspinatus tears (ISTs) between patients with Hamada grade 1 (acromiohumeral distance (AHD) > 6 mm) and those with Hamada grade 2 (AHD ≤ 6 mm).

Methods: A retrospective review was conducted of patients who underwent MTT transfer for ISTs between December 2019 and November 2023. Inclusion criteria included symptomatic tears with severe retraction, advanced fatty infiltration, and minimal glenohumeral osteoarthritis. Clinical outcomes assessed were visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), Constant score, range of motion (ROM), and muscle strength, while radiographic evaluation included AHD and Hamada grade.

Results: Of 124 eligible patients, 112 were analyzed after excluding 12 for incomplete data or loss to follow-up, including 92 with Hamada grade 1 (mean follow-up, 30.6 ± 14.8 months) and 20 with grade 2 (28.6 ± 12.3 months). Both groups showed significant improvements in VAS, ASES, constant scores, forward elevation, and abduction (all p < .001), with no significant between-group differences in pain, functional scores, ROM, or strength at final follow-up (all p > .05). Despite between-group differences in AHD and Hamada grade, AHD did not change significantly within either group.

Conclusion: MTT transfer provides significant pain relief and clinical improvement in patients with ISTs, regardless of preoperative AHD. Postoperative pain, functional scores, ROM, and muscle strength were comparable between Hamada grade 1 and Hamada grade 2 patients at final follow-up.

Level of evidence: IV, retrospective case series.