Arthroscopic-Assisted Lower Trapezius Transfer Augmented by Peroneus Longus Autograft in Irreparable Posterior Superior Rotator Cuff Tears: Functional Outcomes at 24 Months of Follow-up.

Background: Massive irreparable rotator cuff tears are a devastating problem, especially for the middle-aged active population. Tendon transfer seems to be a feasible treatment option for this age group. Biomechanical studies have shown that lower trapezius tendon transfer, rather than latissimus dorsi tendon transfer, could restore the kinematics of the shoulder. Purpose: To evaluate the functional outcome, efficacy, and safety of arthroscopy-assisted lower trapezius transfer with peroneus longus augmentation for irreparable posterior superior rotator cuff tears. Study Design: Case series; Level of evidence, 4. Methods: This study included 20 patients who had massive rotator cuff tears, symptomatic global shoulder pain, and the inability to move their upper limbs actively. The patients were examined by manual testing using a goniometer, and the study had a follow-up period of at least 24 months. Results: The mean age of the patients was 53.4 ± 4.3 years (range, 40-60 years). Thirteen patients had associated biceps pathology. The mean American Shoulder and Elbow Surgeons score improved from 22.88 ± 7.25 preoperatively to 84.44 ± 4.54 postoperative ( Conclusion: Arthroscopy-assisted lower trapezius transfer with peroneus longus augmentation for irreparable rotator cuff tear is advisable because it shows marked improvement in the functional outcome and range of motion without major complications.