The Utility of Lower Trapezius Transfers in Massive Irreparable Posterior- Superior Rotator Cuff Tears

Massive irreparable rotator cuff tears (RCT) present a challenging problem when they occur in the young, active patient population. One treatment option involves tendon transfer, which traditionally has involved the latissimus dorsi transfer (LDT). However, the lower trapezius transfer (LTT) has emerged as an effective alternative with its own set of advantages, such being a tendon transfer that is “in line” and “in phase” with the shoulder functions it restores. Moreover, biomechanical and clinical studies have supported the LTT as an effective treatment option that restores the shoulder function to a great degree with successful outcomes. In this review, we discuss the indications, biomechanics, open and arthroscopic assisted surgical techniques, and outcomes of LTT for massive irreparable RCTs.