Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function

Abstract Purpose Based on its close anatomic features and nearly-collinear force vector to those of supraspinatus muscle, the current article describes a technique of middle trapezius tendon transfer for reproduction of supraspinatus function in the context of rotator cuff irreparability/re-tear man...

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Autor principal:	Amr Abdel-Mordy Kandeel
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Failed rotator cuff repair Irreparable rotator cuff tear Tendon transfer around the shoulder Trapezius tendon transfer Rotator cuff re-tear Rotator cuff tear Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/2b0f38aa4ca2488b9d9c4307e72e95d3
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spelling	oai:doaj.org-article:2b0f38aa4ca2488b9d9c4307e72e95d32021-11-21T12:27:09ZRotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function10.1186/s40634-021-00426-y2197-1153https://doaj.org/article/2b0f38aa4ca2488b9d9c4307e72e95d32021-11-01T00:00:00Zhttps://doi.org/10.1186/s40634-021-00426-yhttps://doaj.org/toc/2197-1153Abstract Purpose Based on its close anatomic features and nearly-collinear force vector to those of supraspinatus muscle, the current article describes a technique of middle trapezius tendon transfer for reproduction of supraspinatus function in the context of rotator cuff irreparability/re-tear management. Methods While seating the patient in beach-chair position, arthroscopic gleno-humeral examination and sub-acromial decompression are initially performed. Hamstring tendons are harvested and fashioned as flattened quadruple sheet. Through McKenzie approach, infraspinatus and subscapularis tendons are repaired. Then, medial half of middle trapezius insertion tendon is harvested from most medial 5-6 cm of the scapular spine. Through McKenzie approach, hamstring sheet is retrieved via a sub-trapezius/sub-acromial corridor from the scapular wound. Hamstring sheet is re-attached to cuff footprint by double row/suture bridge repair configuration. While retracting the scapula and placing gleno-humeral joint in 45O-abduction/45O-external rotation, hamstring sheet is re-attached to released middle trapezius tendon by non-absorbable sutures. Finally, tendon reconstruct is dynamically-tested in different positions of range of motion. Results Transfer of medial portion of middle trapezius insertion tendon (lengthened by interposition hamstring tendon sheet) to cuff footprint was technically feasible. Dynamic testing showed smooth sub-acromial gliding motion of the tendon reconstruct. Conclusion For reproduction of supraspinatus function, hamstring tendon augmented-middle trapezius tendon transfer to cuff footprint heralds a number of technical and biomechanical advantages; thus offering a potential effective modality of cuff irreparability/re-tear management in relatively young patients of high functional demands. However, current description should be investigated in further biomechanical and clinical studies to validate its long-term outcomes.Amr Abdel-Mordy KandeelSpringerOpenarticleFailed rotator cuff repairIrreparable rotator cuff tearTendon transfer around the shoulderTrapezius tendon transferRotator cuff re-tearRotator cuff tearOrthopedic surgeryRD701-811ENJournal of Experimental Orthopaedics, Vol 8, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Failed rotator cuff repair Irreparable rotator cuff tear Tendon transfer around the shoulder Trapezius tendon transfer Rotator cuff re-tear Rotator cuff tear Orthopedic surgery RD701-811
spellingShingle	Failed rotator cuff repair Irreparable rotator cuff tear Tendon transfer around the shoulder Trapezius tendon transfer Rotator cuff re-tear Rotator cuff tear Orthopedic surgery RD701-811 Amr Abdel-Mordy Kandeel Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function
description	Abstract Purpose Based on its close anatomic features and nearly-collinear force vector to those of supraspinatus muscle, the current article describes a technique of middle trapezius tendon transfer for reproduction of supraspinatus function in the context of rotator cuff irreparability/re-tear management. Methods While seating the patient in beach-chair position, arthroscopic gleno-humeral examination and sub-acromial decompression are initially performed. Hamstring tendons are harvested and fashioned as flattened quadruple sheet. Through McKenzie approach, infraspinatus and subscapularis tendons are repaired. Then, medial half of middle trapezius insertion tendon is harvested from most medial 5-6 cm of the scapular spine. Through McKenzie approach, hamstring sheet is retrieved via a sub-trapezius/sub-acromial corridor from the scapular wound. Hamstring sheet is re-attached to cuff footprint by double row/suture bridge repair configuration. While retracting the scapula and placing gleno-humeral joint in 45O-abduction/45O-external rotation, hamstring sheet is re-attached to released middle trapezius tendon by non-absorbable sutures. Finally, tendon reconstruct is dynamically-tested in different positions of range of motion. Results Transfer of medial portion of middle trapezius insertion tendon (lengthened by interposition hamstring tendon sheet) to cuff footprint was technically feasible. Dynamic testing showed smooth sub-acromial gliding motion of the tendon reconstruct. Conclusion For reproduction of supraspinatus function, hamstring tendon augmented-middle trapezius tendon transfer to cuff footprint heralds a number of technical and biomechanical advantages; thus offering a potential effective modality of cuff irreparability/re-tear management in relatively young patients of high functional demands. However, current description should be investigated in further biomechanical and clinical studies to validate its long-term outcomes.
format	article
author	Amr Abdel-Mordy Kandeel
author_facet	Amr Abdel-Mordy Kandeel
author_sort	Amr Abdel-Mordy Kandeel
title	Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function
title_short	Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function
title_full	Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function
title_fullStr	Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function
title_full_unstemmed	Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function
title_sort	rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/2b0f38aa4ca2488b9d9c4307e72e95d3
work_keys_str_mv	AT amrabdelmordykandeel rotatorcuffirreparabilityorfailureofrepairreteartechnicalnoteonmiddletrapeziustendontransferforreproductionofsupraspinatusfunction
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Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function

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