Evaluating the Efficacy of Trapezius Transfer in the Management of Massive Rotator Cuff Tears: A Systematic Review of Clinical Outcomes.

Background: Massive irreparable rotator cuff tears are a significant challenge for shoulder function, with tendon transfers emerging as potential solutions.

Objective: This systematic review aims to comprehensively evaluate the current evidence on the outcomes of lower trapezius transfer for the treatment of massive rotator cuff tears.

Methods: This systematic review examines the use of trapezius transfer in managing these tears. Following PRISMA guidelines, a search of Medline, Embase, and Cochrane was conducted through March 2024 for studies on trapezius tendon transfer.

Results: The review analyzed data from 214 patients (161 males, 53 females) with an average age of 58 years (range: 31-73 years), focusing on surgical technique, complications, follow-up duration, and outcomes. Most procedures utilized an Achilles allograft, with reported complications including retear rates of 7.5% and surgical infections in 2.3% of cases. The average follow-up was 38.4 months, with 80% to 100% of patients returning to previous activity levels.

Conclusion: This review highlights the effectiveness of lower trapezius tendon transfer, particularly using an Achilles allograft, in enhancing pain relief, shoulder mobility, and overall function. Despite some complications, the high return-to-activity rate underscores the procedure's utility in restoring normalcy and productivity for patients with massive rotator cuff tears. Future research should aim to standardize operative and postoperative protocols to optimize outcomes and reduce complications.